Discussion
Local and national guidance have helped in creating best practice models for teams to adhere to across the UK, reassuring teams of their personal safety when performing aerosol generating procedures in COVID -19 patients.
The recent emergence of this disease in the UK has meant that robust outcome data is yet to be established. Although there has been a recent series of 51 patients undergoing percutaneous tracheostomy [8], there have been no published series of solely surgical tracheostomy outcomes in COVID-19.
There was good adherence to our local and national guidance for both timing and level of ventilatory support prior to tracheostomy suggesting robust processes locally to ensure tracheostomies are being performed appropriately [1].
We believe modifications to the standard surgical tracheostomy technique represents a safe technique for patients and staff alike. Although there is no definite evidence to guide which of percutaneous or surgical techniques are less aerosol generating, no staff members involved in our series or that of Takhar et al have tested positive for COVID-19 in the post-operative period [9].
Whilst this initial study is limited in terms of numbers and follow up duration, there are many positive aspects which support the continued use of the national guidance. Complication rates were low (15%) and comparable to the published literature [10]. This early data on surgical tracheostomy outcomes, demonstrates that it is a safe technique in this cohort of patients and should help to give hospitals around the country confidence to continue to perform this procedure, via the technique they are most comfortable with, whilst further evidence is collected.
Words 1476