Risk management during COVID-19: safety procedures for otolaryngologists Risk management for otolaryngologists

Main Article Content

Giacomo Spinato
Piergiorgio Gaudioso
Paolo Boscolo Rizzo
Cristoforo Fabbris
Anna Menegaldo
Francesca Mularoni
Bhuvanesh Singh
Antonino Maniaci
Salvatore Cocuzza
Daniele Frezza

Keywords

COVID-19; Risk Management; Personal protective equipment; SARS-CoV2; Head and Neck Surgery

Abstract

The pandemic caused by SARS-CoV2 has stressed health care systems worldwide. The high volume of patients, combined with an increased need for intensive care and potential transmission, has forced reorganization of hospitals and care delivery models. In this article, are presented approaches to minimize risk to Otolaryngologists during their patients infected with COVID-19 care. We performed a narrative literature review among PubMed, Scopus and Web of Science electronic databases, searching for studies on SARS-CoV2 and Risk Management. Standard operating procedures have been adapted both for facilities and for health care workers, including the development of well-defined and segregated patient care areas for treating those affected by COVID-19. Personal protective equipment (PPEs) availability and adequate healthcare providers training on their use should be ensured. Preventive measures are especially important in Otolaryngology-Head and Neck Surgery, as the exposure to saliva suspensions, droplets and aerosols are increased in the upper aero-digestive tract routine examination. Morever, the frequent invasive procedures, such as laryngoscopy, intubation or tracheotomy placement and care, represent a high risk of contracting COVID-19.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...
Abstract 117 | PDF Downloads 51

References

1. Istituto Superiore di Sanità, Epidemia COVID-19. Aggiornamento nazionale 4 Settembre 2020. Available at: http://www.salute.gov.it
2. Federazione Nazionale degli Ordini dei Medici Chiurghi e degli Odontoiatri, Elenco dei Medici caduti nel corso dell’epidemia di Covid-1. Available at: https://portale.fnomceo.it/elenco-dei-medici-caduti-nel-corso-dellepidemia-di-covid-19/
3. Istituto Superiore di Sanità, ISS COVID-19 n. 2/2020 Rev. - Indicazioni ad interim per un utilizzo razionale delle protezioni per infezione da SARS-COV-2 nelle attività sanitarie e sociosanitarie (assistenza a soggetti affetti da COVID-19) nell’attuale scenario emergenziale SARS-COV-2. Aggiornato al 10 Maggio 2020.
4. Tang D, Tou J, Wang J, et al. Prevention and control strategies for emergency, limited-term, and elective operations in pediatric surgery during the epidemic period of COVID-19. World Jnl Ped Surgery 2020; 3:e000122. Doi:10.1136/ wjps-2020-000122
5. Maniaci A, Iannella G, Vicini C, et al. A Case of COVID-19 with Late-Onset Rash and Transient Loss of Taste and Smell in a 15-Year-Old Boy. Am J Case Rep 2020; 21:e925813. doi: 10.12659/AJCR.925813.
6. McArthur L, Sakthivel D, Ataide R, Chan F, Richards JS, Narh CA. Review of Burden, Clinical Definitions, and Management of COVID-19 Cases. Am J Trop Med Hyg 2020; 103(2):625-638. doi:10.4269/ajtmh.20-0564
7. Gasmi A, Noor S, Tippairote T, Dadar M, Menzel A, Bjørklund G. Individual risk management strategy and potential therapeutic options for the COVID-19 pandemic. Clin Immunol 2020; 215:108409. doi:10.1016/j.clim.2020.108409
8. National Health Commission of the People’s Republic of China. Announcement on the issuance of technical guidelines for the prevention and control of the new coronary virus infections in medical institutions (first edition) (in Chinese). Available: http:// www.nhc.gov.cn/xcs/yqfkdt/202001/b91fdab7c304431eb082d678 47d27e14.shtml
9. Ministero della salute, Protocollo per il monitoraggio degli eventi sentinella, available http://www.salute.gov.it/imgs/C_17_pubblicazioni_1783_allegato.pdf
10. Home care for patients with COVID-19 presenting with mild symptoms and management of their contacts: interim guidance. Geneva: World Health Organization; 2020
11. James Reason, The Human Contribution, 2010-Hirelia Srl, Milano, IT; Edizione italiana a cura di Hirelia Edizioni
12. J. R. Katzenbach and D. K. Smith, The Wisdom of Teams, Harvard Business Review Press, 2015
13. Guo WY, Yuan JP, Fu T, et al. Perioperative prevention and control strategies for surgical patients in the context of new coronavirus pneumonia (in Chinese). Chin J Dig Surg 2020; 19:E001.
14. Charles Vincent, Patient Safety, Springer-Verlag Italia 2011, DOI 10.1007/978-88-470-1875-4
15. World Helath Organization, Rational use of personal protective equipment (PPE) for coronavirus disease (COVID-19) and considerations during severe shortages, Interim guidance 6 April 2020, WHO/2019-nCoV/IPC PPE_use/2020.2
16. Infection prevention and control of epidemic-and pandemic-prone acute respiratory infections in health care. Geneva: World Health Organization; 2014.
17. Società Italiana di Otorinolaringoiatria e Chirurgia Cervico Facciale, Accesso all’ambulatorio ORL in corso di pandemia da SARS-COV-2, available: https://www.sioechcf.it/wp-content/uploads/2020/03/Accesso-allambulatorio-ORL-in-corso-di-pandemia-da-SARS-COV-2.pdf
18. Givi B, Schiff BA and Chinn SB. "Safety recommendations for evaluation and surgery of the head and neck during the COVID-19 pandemic [published online ahead of print March 31, 2020]." JAMA Otolaryngol Head Neck Surg. doi:10.1001/jamaoto.2020.0780
19. Xu K, Lai XQ, and Liu Z. "Suggestions for prevention of 2019 novel coronavirus infection in otolaryngology head and neck surgery medical staff." Zhonghua er bi yan hou tou jing wai ke za zhi= Chinese journal of otorhinolaryngology head and neck surgery 55 (2020): E001-E001.
20. Spinato G, Fabbris C, Polesel J, et al. Alterations in Smell or Taste in Mildly Symptomatic Outpatients With SARS-CoV-2 Infection. JAMA 2020; 323(20):2089‐2090. doi:10.1001/jama.2020.6771.
21. Boscolo-Rizzo P, Borsetto D, Fabbris C, et al. Evolution of Altered Sense of Smell or Taste in Patients With Mildly Symptomatic COVID-19. JAMA Otolaryngol Head Neck Surg 2020; 146(8):729-732. doi:10.1001/jamaoto.2020.1379.
22. Borsetto D, Hopkins C, Philips V, et al. Self-reported alteration of sense of smell or taste in patients with COVID-19: a systematic review and meta-analysis on 3563 patients. Rhinology 2020; 10.4193/Rhin20.185. doi:10.4193/Rhin20.185
23. Boscolo-Rizzo P, Borsetto D, Spinato G, et al. New onset of loss of smell or taste in household contacts of home-isolated SARS-CoV-2-positive subjects. Eur Arch Otorhinolaryngol 2020; 277(9):2637-2640. doi:10.1007/s00405-020-06066-9
24. Pichi B, Mazzola F, Bonsembiante A, et al. CORONA-steps for tracheotomy in COVID-19 patients: A staff-safe method for airway management. Oral Oncol 2020; 105:104682. doi:10.1016/j.oraloncology.2020.104682
25. Tay JK, Khoo MLC, Loh WS. Surgical considerations for tracheostomy during the COVID‐19 pandemic: lessons learned from the severe acute respiratory syndrome outbreak. JAMA Otolaryngol Head Neck Surg, 10.
26. ENTUK, Aerosol-generating procedures in ENT, available: https://www.entuk.org/sites/default/files/files/Aerosol-generating%20procedures%20in%20ENT_compressed.pdf
27. Società Italiana di Otorinolaringoiatria e Chirurgia Cervico Facciale, La tracheostomia in pazienti affetti da COVID-19; available: https://www.sioechcf.it/wp-content/uploads/2020/03/La-tracheostomia-in-pazienti-affetti-da-COVID-19.pdf
28. ENTUK, COVID-19 Tracheostomy, Framework for open tracheostomy in COVID-19 patients, available: https://www.entuk.org/sites/default/files/files/COVID%20tracheostomy%20guidance_compressed.pdf
29. China Newsweek.View.inews.qq.com/a/20200125A07TT200?uid=&devid=BDFE70CD-5BF1-4702-91B7- 329F20A6E839&qimei=bdfe70cd-5bf1-4702-91b7-329f20a6E839
30. Società italiana del basicranio, Chirurgia del basicranio durante l’emergenza COVID-19, available: https://societabasicranio.it/altreimg/SIB-raccomandazioni_covid-19.pdf
31. ENTUK, Nasal endoscopy and laryngoscopy examination of ENT patients, available: https://www.entuk.org/sites/default/files/files/Nasal%20endoscopy%20and%20laryngoscopy%20examination%20of%20ENT%20patients_compressed.pdf
32. 3https://www.bloomberg.com/news/articles/2020-03-17/europe-s-doctors-getting-sick-like-in-wuhan-chinesedoctors say?fbclid=IwAR2ds9OWRxQuMHAuy5Gb7ltqUGMZNSojVNtFmq3zzcSLb_bO9aGYr7URxaI
33. Patel ZM, Fernandez-Miranda J, Hwang PH, Nayak JV, Dodd R, Sajjadi H, Jackler RK. Letter: Precautions for Endoscopic Transnasal Skull Base Surgery During the COVID-19 Pandemic. Neurosurgery 2020; 87(1):E66-E67. doi: 10.1093/neuros/nyaa125.
34. Società Italiana di Otorinolaringoiatria e Chirurgia Cervico Facciale, Attività chirurgica ORL durante la pandemia da COVID-19; available: https://www.sioechcf.it/wp-content/uploads/2020/03/Sala-operatoria-ORL-COVID.pdf
35. ENTUK, Guidance PPE for patients with emergency oropharyngeal and nasopharyngeal conditions whose COVID Status is unknown, available: https://www.entuk.org/sites/default/files/files/BAOMS%20ENT%20COVID%20Advice%20Update%2025%20March%202019%20Final.pdf
36. Handbook of COVID-19 Prevention and Treatment. Available at: https://esge.org/documents/Handbook_of_COVID-19_Prevention_and_Treatment.pdf
37. Chan JYK, Wong EWY, Lam W. Practical Aspects of Otolaryngologic Clinical Services During the 2019 Novel Coronavirus Epidemic: An Experience in Hong Kong. JAMA Otolaryngol Head Neck Surg. 2020;146(6):519–520. doi:10.1001/jamaoto.2020.0488
38. Pearlman AN, Tabaee A, Sclafani AP, et al. Establishing an Office-Based Framework for Resuming Otolaryngology Care in Academic Practice During the COVID-19 Pandemic. Otolaryngol Head Neck Surg 2020; 194599820955178. doi:10.1177/0194599820955178