Percutaneous tracheostomy surgical technique in the patient with COVID-19

Abstract

Background: Since December 2019, a new respiratory infection was detected, caused by the virus called SARSCoV-2, later decreed as a pandemic, which has required health personnel to rethink the way of providing their health services and guarantee the self-protection with resources that have been insufficient even in the most developed countries. As the transmission of SARS-CoV-2 occurs through aerosols expelled from the airway, which can be inhaled or brought to the mucosa by contact with contaminated hands, it is necessary to minimize the possibility of contagion for the health care teams. Objectives: Provide tools to surgeons that allow them to choose the technique with the least probability of exposure to aerosols. Describe the step-by-step of the percutaneous tracheostomy technique, emphasizing control about the generation of aerosols in critical steps. Technical aspects: The fully percutaneous technique with a tracheostomy kit allows a better seal between tissues and devices. The most frequent scenarios for performing a tracheostomy are an intubated patient with mechanical ventilation and a patient with failure of intubation that requires emergency intervention. Conclusion: The high contagion of COVID-19 when practicing airway interventions forces us to emphasize strategies that reduce the formation of aerosols and allow them to be contained during tracheostomies.