Introduction
The ongoing COVID-19 pandemic has resulted in unprecedented pressure on critical care and requirements for mechanical ventilation. Tracheostomy (both percutaneous and surgical techniques) play an established role in mechanically ventilated patients to aid weaning, decrease sedation, and facilitate step down to level two and ward- based care. In the COVID-19 setting, the situation continues to rapidly evolve, with recommendations to date based on expert opinion rather than robust evidence.
The increased demand for performing tracheostomies, either surgically or percutaneously, in COVID -19 presents problems due to the potential for aerosol generation. Here we share our experience in formulating a COVID -19 tracheostomy standard operating procedure (SOP) to mitigate that risk, and the outcomes of our first 18 surgical tracheostomies in COVID-19 patients.