Survey of UPMC Tracheostomy Providers
A brief survey focusing on tracheostomy practices during March and April
2020 was completed by Otolaryngologists, General Surgeons, and Thoracic
Surgeons at the UPMC Oakland campus. Providers were asked to respond how
often certain practices were being used during the procedure: always,
usually, about half the time, seldom, or never (Figure 3). In addition,
providers were asked to provide suggestions for tracheostomy time-out
design especially with regards to key safety measures. A total of 15
providers responded of which 9 had performed tracheostomies in this
timeframe (6 Otolaryngologists, 2 General Surgeons, and 1 Thoracic
Surgeon). Each provider performed an average of 3 tracheostomies (range:
1-6). None of the patients had confirmed COVID-19 infection although
four patients were under investigation at time of procedure. Most
providers (77%; 7/9) performed open tracheostomies compared to
percutaneous approach. On average, two members of the surgical team were
present for the procedure (range: 1-3). Only one of the providers noted
using a negative pressure room for the tracheostomy. Most providers
reported always using the following practices: wearing an N95 mask
(66%, 6/9), patient paralysis (66%, 6/9), holding ventilation with
open respiratory circuit (77%, 7/9), and using cuffed tracheostomy tube
(88%, 8/9). Only three providers noted waiting for COVID-19 status
before performing the tracheostomy tube change. Providers frequently
performed the trach change between post-op days 5 to 10 (38%, 3/8) or
after 10 days (38%, 3/8); only 2 providers performed the trach change
on post-op day 5.