Speech-Language Pathology Guidance for Tracheostomy During the COVID-19 Pandemic: An International Multidisciplinary Perspective
Speech-Language Pathology Guidance for Tracheostomy During the COVID-19 Pandemic: An International Multidisciplinary Perspective
复制标题
DOI：
10.1044/2020_ajslp-20-00089
复制
发表时间：
2020-08-01
影响因子：
2.6
通讯作者：
Brenner, Michael J.
中科院分区：
文献类型：
--
作者：
Zaga, Charissa J.;Pandian, Vinciya;Brenner, Michael J.
目的：随着COVID-19大流行的展开，人们越来越认识到一线卫生保健工作者面临的风险。在护理气管切开术患者时，语言病理学家会大量接触可能含有SARS-CoV-2病毒的粘膜表面、分泌物和气溶胶。本教程为安全执行患者评估和程序的实践提供指导，从而降低感染风险。方法：通过查阅与COVID-19和类似高继发性感染相关的文献、指南和共识声明来整理数据，重点是降低向卫生保健工作者传播的风险。特别强调的是语言病理学家、护士和其他相关的卫生专业人员。然后，一个多国跨学科小组分析了调查结果，通过电子通信和视频会议达成共识，提出了建议。结果：在当前的COVID-19大流行和以前的疫情中，卫生保健工作者感染传播的报告证实了安全做法的必要性。语言病理学家常规操作的许多程序由于气溶胶的产生而有很大的感染风险。COVID-19检测可以告知防护设备的水平，细致的卫生可以阻止医院感染的传播。通常需要对气管切开术的标准临床实践进行修改。在对已知或疑似感染COVID-19的患者进行产生气溶胶的手术时，需要个人防护装备，包括电动空气净化呼吸器或N95口罩、手套、护目镜和防护服。结论：经常需要语言病理学家协助护理气管切开术并已知或疑似感染COVID-19的患者。对这些患者的适当护理是基于维护医疗团队的健康和安全。认真遵守最佳做法可大大降低传染性传播的风险。
Purpose: As the COVID-19 pandemic has unfolded, there has been growing recognition of risks to frontline health care workers. When caring for patients with tracheostomy, speech-language pathologists have significant exposure to mucosal surfaces, secretions, and aerosols that may harbor the SARS-CoV-2 virus. This tutorial provides guidance on practices for safely performing patient evaluation and procedures, thereby reducing risk of infection.Method: Data were collated through review of literature, guidelines, and consensus statements relating to COVID-19 and similar high-consequent infections, with a focus on mitigating risk of transmission to health care workers. Particular emphasis was placed on speech-language pathologists, nurses, and other allied health professionals. A multinational interdisciplinary team then analyzed findings, arriving at recommendations through consensus via electronic communications and video conference.Results: Reports of transmission of infection to health care workers in the current COVID-19 pandemic and previous outbreaks substantiate the need for safe practices. Many procedures routinely performed by speech-language pathologists have a significant risk of infection due to aerosol generation. COVID-19 testing can inform level of protective equipment, and meticulous hygiene can stem spread of nosocomial infection. Modifications to standard clinical practice in tracheostomy are often required. Personal protective equipment, including either powered air-purifying respirator or N95 mask, gloves, goggles, and gown, are needed when performing aerosol-generating procedures in patients with known or suspected COVID-19 infection.Conclusions: Speech-language pathologists are often called on to assist in the care of patients with tracheostomy and known or suspected COVID-19 infection. Appropriate care of these patients is predicated on maintaining the health and safety of the health care team. Careful adherence to best practices can significantly reduce risk of infectious transmission.