A discussion on strategic considerations, effective safety measures and procedural deliberations in otorhinolaryngology practice and surgery during COVID-19: an integrative approach (original) (raw)
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Rhinology Online
COVID-19’s rapid sweep across the world has caused an extraordinary disruption to the otorhinolaryngology (ORL) profession and its subspecialties including the rhinology section. The present pandemic forced our specialty practitioners to make quick clinical and practice management decisions. Staff safety must receive the highest prioritization along with strategies to provide the highest quality care. The purpose of the present manuscript is to provide a narrative review of the current knowledge and committee practices regarding ORL (including rhinology) professionals' safe practice during COVID-19 pandemic and after reopen process. The present review findings will allow the clinical practitioners to understand the factors involved in reducing the risk of transmission of COVID-19 in the ORL and rhinology settings, personal protective equipment (PPE) for different ORL and rhinology practices and criteria of practice in outpatient clinic (OPC), emergency operations and ORL surgeri...
Modified office practice in COVID-19 pandemic - an otorhinolaryngologist perspective
International Journal Of Community Medicine And Public Health
COVID-19 spreads through contact, minute droplets and aerosol from infected person which may be symptomatic or asymptomatic. Nose and throat had very high load of severe acute respiratory syndrome (SARS-CoV-2) virus. Otorhinolaryngologists by virtue of their work which requires close examination of these part are at very high risk of infection. Many studies are available for precautions to be taken in patient management related to COVID-19 in wards and surgical intervention in operation theaters but very little information is available regarding precautions in working in outpatient clinic setting. Our article highlights some changes we made in ear, nose and throat (ENT) outpatient clinics after going through various guidelines to make it safe in current scenario. These changes may inspire others to move toward safer work practices in their outpatient area to provide ENT consultations. The main changes were categorized into infrastructural changes, identification of frugal but effect...
Philippine Journal of Otolaryngology Head and Neck Surgery, 2020
Objective: To review available resources and provide evidence-based recommendations that may optimize otorhinolaryngologic out-patient health care delivery in the “post”-COVID-19 era while ensuring the safety of our patients, healthcare workers and staff. Data Sources: Relevant peer-reviewed journal articles; task force, organizational and institutional, government and non-government organization recommendations; published guidelines from medical, health-related, and scientific organizations. Methods: A comprehensive review of the literature on the COVID-19 pandemic as it pertained to “post”-COVID 19 out-patient otorhinolaryngologic practice was obtained from peer-reviewed articles, guidelines, recommendations, and statements that were identified through a structured search of the data sources for relevant literature utilizing MEDLINE (through PubMed and PubMed Central PMC), Google (and Google Scholar), HERDIN Plus, the World Health Organization (WHO) Global Health Library, and grey...
Guidelines for otorhinolaryngologists and head neck surgeons in coronavirus disease 2019 pandemic
Guidelines for otorhinolaryngologists and head neck surgeons in coronavirus disease 2019 pandemic, 2021
Background: Coronavirus disease 2019 was first identified in Wuhan, the capital of China's Hubei province, in December 2019. India has witnessed a massive surge of coronavirus cases. Main text: This study details the measures to be taken by the clinicians involved in doing otorhinolaryngology and head neck surgery in light of the recent coronavirus disease 2019 pandemic. All COVID-positive patients should be admitted in a separate COVID ward, and patients should be screened for COVID-19 before admission. Only emergent ENT surgeries should be done in an operating room having a negative pressure environment with high-frequency air changes, and all staff must wear personal protective equipment. The anesthetist intubates the patient while the surgical team waits outside the operation theater post-intubation for 21 min. For otology surgery, double draping of the microscope should be done; for rhinology surgery, concept of negative-pressure otolaryngology viral isolation drape (NOVID) system should be used. Smoke evacuation system is set up inside the tent to evacuate any smoke produced during the surgery. Tracheostomy should be done at least after 10 days of mechanical ventilation with cuffed, non-fenestrated tracheal tube inserted through the tracheal window, and a separate closed suction system is used for suctioning. After the surgery is completed, disposal of PPE kit needs to be done according to local guidelines. After completion of the surgery, the full anesthesia unit should be disinfected for 2 h with 12 % hydrogen peroxide. Chlorine-containing disinfectant (2000 mg/L) is used to clean the floor of the operation theater and clean all the reusable medical equipment. Ultra-low volume 20 to 30 mL/m of 3% hydrogen peroxide is used to fumigate the OT for 2 h. Conclusions: COVID-19 is a newly discovered infectious disease. Measures need to be taken to prevent transmission and attain a plateau and decline in the disease. Otorhinolaryngologists and head neck surgeons are at high risk of this infection. This review summarizes the protocol for otorhinolaryngologists and head neck surgeons caring for patients in this current scenario. Protocols need to be strictly followed to prevent the spread of this disease.
Journal of Otolaryngology - Head & Neck Surgery
The 2019 novel coronavirus disease (COVID-19) epidemic originated in Wuhan, China and spread rapidly worldwide, leading the World Health Organization to declare an official global COVID-19 pandemic in March 2020. In Hong Kong, clinicians and other healthcare personnel collaborated closely to combat the outbreak of COVID-19 and minimize the cross-transmission of disease among hospital staff members. In the field of otorhinolaryngology—head and neck surgery (OHNS) and its various subspecialties, contingency plans were required for patient bookings in outpatient clinics, surgeries in operating rooms, protocols in wards and other services. Infected patients may shed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) particles into their environments via body secretions. Therefore, otolaryngologists and other healthcare personnel in this specialty face a high risk of contracting COVID-19 and must remain vigilant when performing examinations and procedures involving the nose and...
Indian Journal of Otolaryngology and Head & Neck Surgery
To study the effect of COVID-19 pandemic on patient load in a tertiary care centre and the innovations and methods used to improve the safety of the healthcare workers, to provide adequate treatment in the department of Otorhinolaryngology. This study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery, at a tertiary care hospital centre in North-East India. This study included data collected from the patient registers maintained in our department, and included data over a 4-month period, from April, 2020 to July, 2020. Age, gender, place of residence, clinical diagnosis and the operative procedure performed were included in the data profile for analysis. The above-mentioned registers were also reviewed to retrieve details about the rate of admission during the study period in the previous year. Data was collected and represented, in both descriptive and tabular forms, after proper statistical analysis. We found out that there is a drastic reduction in n...
Otolaryngology during COVID-19: Preventive care and precautionary measures
American Journal of Otolaryngology, 2020
Since the outbreak of novel coronavirus disease (COVID-19) in December 2019, it has spread to various regions and countries, forming a global pandemic. Reducing nosocomial infection is a new issue and challenge for all healthcare systems. Otolaryngology is a high-risk specialty as it close contact with upper respiratory tract mucous, secretions, droplets and aerosols during procedures and surgery. Therefore, infection prevention and control measures for this specialty are essential. Literatures on the epidemiology, clinical characteristics and infection control measures of COVID-19 were reviewed, practical knowledge from first-line otolaryngologists in China, the United States, and Brazil were reviewed and collated. It was recommended that otolaryngology professionals should improve screening in suspected patients with relevant nasal and pharyngeal symptoms and signs, suspend non-emergency consultations and examinations in clinics, and rearrange the working procedures in operating rooms. The guidelines of personal protective equipment for swab sampling, endoscopy and surgery were listed. Indications for tracheotomy during the pandemic should be carefully considered to avoid unnecessary airway opening and aerosol-generation; precautions during surgery to reduce the risk of exposure and infection were illustrated. This review aimed to provide recommendations for otolaryngologists to enhance personal protection against COVID-19 and reduce the risk of nosocomial infection. Human to human transmission of SARS-CoV-2 has been confirmed [16], and the infection is highly contagious with about 2.2-3.6 basic
Journal of Otolaryngology - Head & Neck Surgery, 2020
The novel Coronavirus (COVID-19) has created a worldwide deadly pandemic that has become a major public health challenge. All semi-urgent and elective medical care has come to a halt to conserve capacity to care for patients during this pandemic. As the numbers of COVID-19 cases decrease across Canada, our healthcare system also began to reopen various facilities and medical offices. The aim for this document is to compile the current evidence and provide expert consensus on the safe return to clinic practice in Otolaryngology – Head & Neck Surgery. These recommendations will also summarize general precaution principles and practical tips for office across Canada to optimize patient and provider safety. Risk assessment and patient selection are crucial to minimizing exposure to COVID-19. Controversial topics such as COVID-19 mode of transmission, duration of exposure, personal protective equipment, and aerosol-generating procedures will be analyzed and discussed. Practical solutions...
Malaysian Journal of Medical Sciences, 2021
COVID-19 has taken the world by storm: since the first few cases appeared in Wuhan, China in December 2019 and by June 2020 there were more than 10 million cases of COVID-19 cases worldwide. Malaysia had its first case in January 2020 and acted promptly by implementing several drastic measures to contain the disease. Subsequently, the Ministry of Health Malaysia has implemented guidelines and recommendations on the management of COVID-19. The Department of Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) provides services for patients with ear, nose, throat, head and neck diseases and provides audiology, speech and language therapy, as well as undergraduate and postgraduate training. As the department’s staff is heavily involved in examinations and interventions of upper aerodigestive tract problems, the challenges are distinctly different from other specialties. This article discusses how COVID-19 affected ORL-HNS services and what measures were taken in Hospital Melaka, Malaysia.
Otorhinolaryngologists and head-and-neck surgeons are considered as high-risk group of health-care workers due to their nature of work for exposure to the respiratory tract. During routine assessment and treatment of patients, otorhinolaryngologists and head-and-neck surgeons with their assisting staffs inevitably come in contact with secretions of the respiratory tract which may become aerosolized at time of the sneeze or cough. All otorhinolaryngology patients must be considered as potential carriers of COVID-19. A great emphasis must be given on the history such as flu-like symptoms, travel history, and contact history with potential carriers which will help triage patients into high risk. This review article discusses the infection control measures by otolaryngological and head-and-neck perspective during COVID-19 pandemic so will serve as template for otolaryngologists and head-and-neck specialist at the time of this outbreak.