Discussion
Tracheostomies are a common surgical procedure performed by
otolaryngologists in both the emergent and elective setting.
Additionally, there may be some expanding indications in the COVID-19
patient population. As COVID-19 patients wean off the ventilator, some
may be at high risk for requiring non-invasive ventilation or
reintubation. Both instances have been noted to be aerosol-generating
events, and should be avoided when possible. Ventilation using a
tracheostomy has many potential benefits including providing
closed-circuit respiratory support, allowing for decreased sedation, and
requiring less intensive nursing care (6). Discussion between intensive
care and otolaryngology teams should take place to decide whether
tracheostomy is indicated in this patient population. In patients
testing positive for COVID-19, this summary of recommendations serves as
a guideline along with institutional protocols.