Video laryngoscopy in COVID-19 patients: a word of caution

Singh, Neha; Rao, P.Bhaskar; Mishra, Nitasha

doi:10.1007/s12630-020-01677-6

Cited by 9 publications

(7 citation statements)

References 3 publications

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“…during infectious, epidemic situations as a risk reduction method, such as during COVID-19 [21,22]. However, our results show that junior learners remained unimproved.…”

Section: Plos Onementioning

confidence: 53%

Does seniority always correlate with simulated intubation performance? Comparing endotracheal intubation performance across medical students, residents, and physicians using a high-fidelity simulator

Yau

Chang

et al. 2021

PLoS ONE

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Background Endotracheal intubation is crucial in emergency medical care and anaesthesia. Our study employed a high-fidelity simulator to explore differences in intubation success rate and other skills between junior and senior physicians. Methods We examined the performance of 50 subjects, including undergraduate students (UGY), postgraduate trainees (PGY), residents (R), and attending physicians (VS). Each participant performed 12 intubations (i.e. 3 devices x 4 scenarios) on a high-fidelity simulator. Main outcome measures included success rate, time for intubation, force applied on incisor and tongue, and Cormack Lehane grades. Results There was no primary effect of seniority on any outcome measure except success rate and Cormack Lehane grades. However, VS demonstrated shorter duration than medical students using Glidescope and direct laryngoscopy, whereas VS and R applied significantly more force on the incisor in the normal airway and rigid neck scenario respectively. Discussion Seniority does not always correlate with skill perfection in detailed processes. Our study suggests that the use of video laryngoscopy enhances the intubation success rate and speed, but the benefit only accrues to senior learners, whereby they applied more force on the incisor at a single peak under difficult scenarios. These findings are discussed in terms of psychological and cognitive perspectives. Conclusion Speed and safety are essential for high quality critical medical procedures. A tool should be designed and implemented to educate junior physicians with an emphasis on practice and efficiency, which should also contribute to updating senior physicians’ knowledge and competence by providing instant feedback on their performance. This type of fine-grained feedback could serve as a complement to traditional training and provide a sustainable learning model for medical education.

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“…during infectious, epidemic situations as a risk reduction method, such as during COVID-19 [21,22]. However, our results show that junior learners remained unimproved.…”

Section: Plos Onementioning

confidence: 53%

Does seniority always correlate with simulated intubation performance? Comparing endotracheal intubation performance across medical students, residents, and physicians using a high-fidelity simulator

Yau

Chang

et al. 2021

PLoS ONE

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“…FEES involves nasolaryngoscopy, is an AGP, and requires physical proximity to the patient. Videofluoroscopic swallow study (VFSS), another alternative swallow assessment, may involve patient transport 123–125 . In pediatric patients, there is often crying and sputtering with FEES and VFSS, which may increase aerosolized particles.…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary Safety Recommendations After Tracheostomy During COVID‐19 Pandemic: State of the Art Review

Meister

Pandian

Hillel

et al. 2020

Otolaryngol.--head neck surg.

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Objective In the chronic phase of the COVID-19 pandemic, questions have arisen regarding the care of patients with a tracheostomy and downstream management. This review addresses gaps in the literature regarding posttracheostomy care, emphasizing safety of multidisciplinary teams, coordinating complex care needs, and identifying and managing late complications of prolonged intubation and tracheostomy. Data Sources PubMed, Cochrane Library, Scopus, Google Scholar, institutional guidance documents. Review Methods Literature through June 2020 on the care of patients with a tracheostomy was reviewed, including consensus statements, clinical practice guidelines, institutional guidance, and scientific literature on COVID-19 and SARS-CoV-2 virology and immunology. Where data were lacking, expert opinions were aggregated and adjudicated to arrive at consensus recommendations. Conclusions Best practices in caring for patients after a tracheostomy during the COVID-19 pandemic are multifaceted, encompassing precautions during aerosol-generating procedures; minimizing exposure risks to health care workers, caregivers, and patients; ensuring safe, timely tracheostomy care; and identifying and managing laryngotracheal injury, such as vocal fold injury, posterior glottic stenosis, and subglottic stenosis that may affect speech, swallowing, and airway protection. We present recommended approaches to tracheostomy care, outlining modifications to conventional algorithms, raising vigilance for heightened risks of bleeding or other complications, and offering recommendations for personal protective equipment, equipment, care protocols, and personnel. Implications for Practice Treatment of patients with a tracheostomy in the COVID-19 pandemic requires foresight and may rival procedural considerations in tracheostomy in their complexity. By considering patient-specific factors, mitigating transmission risks, optimizing the clinical environment, and detecting late manifestations of severe COVID-19, clinicians can ensure due vigilance and quality care.

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“…Avoid awake fiber optic intubation and preferably use video laryngoscope. 21 Preoxygenate with minimal gas flow possible, i.e. less than 6 L per min, ensure good seal with face mask; give fentanyl slowly, in small aliquots if required to reduce coughing.…”

Section: Anesthesia Protocolsmentioning

confidence: 99%

Guidelines for oral, pharyngeal and laryngopharyngeal surgery during COVID-19 pandemic

Husain¹,

Husain²,

Ahmed³

2021

Int J Otorhinolaryngol Head Neck Surg

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<p class="abstract">The pandemic due to the new respiratory infection known as coronavirus 2019 disease (COVID-19), caused by the SARS-CoV-2 virus, has triggered an unprecedented disruption in the normal activity of ENT, oral, and pharyngeal surgery departments worldwide, delaying routine patient care and elective surgical interventions. ENT, oral, and pharyngeal surgeons are one of the healthcare groups with the highest risk of nosocomial infection because of the close contact that occurs with asymptomatic and symptomatic patients with SARS-CoV-2 infection through the oral cavity and laryngopharynx. The purpose of this document has been to update the available evidence for the safe and effective management and treatment in elective and emergency surgeries, and hospitalization, while minimizing as much as possible the risk of infection for the ENT, oral, and laryngopharyngeal surgeon, health workers and patients. This document aims to clarify the most significant aspects and develop a common protocol for the surgical management of patients with COVID-19 in ENT, oral, and maxillofacial surgery during the acute stage of spread and subsequent control of the pandemic in our country.</p>

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Video laryngoscopy in COVID-19 patients: a word of caution

Cited by 9 publications

References 3 publications

Does seniority always correlate with simulated intubation performance? Comparing endotracheal intubation performance across medical students, residents, and physicians using a high-fidelity simulator

Does seniority always correlate with simulated intubation performance? Comparing endotracheal intubation performance across medical students, residents, and physicians using a high-fidelity simulator

Multidisciplinary Safety Recommendations After Tracheostomy During COVID‐19 Pandemic: State of the Art Review

Guidelines for oral, pharyngeal and laryngopharyngeal surgery during COVID-19 pandemic

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