PURPOSE Critical care nurses caring for patients with a tracheostomy are at high risk because of the predilection of SARS-CoV-2 for respiratory and mucosal surfaces . This review identifies patient-centered practices that ensure safety and reduce risk of infection transmission to health care workers during the coronavirus disease 2019 (COVID-19) pandemic .
METHODS Consensus statements, guidelines, institutional recommendations, and scientific literature on COVID-19 and previous outbreaks were reviewed . A global interdisciplinary team analyzed and prioritized findings via electronic communications and video conferences to develop consensus recommendations .
RESULTS Aerosol-generating procedures are commonly performed by nurses and other health care workers, most notably during suctioning, tracheostomy tube changes, and stoma care . Patient repositioning, readjusting circuits, administering nebulized medications, and patient transport also present risks . Standard personal protective equipment includes an N95/FFP3 mask with or without surgical masks, gloves, goggles, and gown when performing aerosol-generating procedures for patients with known or suspected COVID-19 . Viral testing of bronchial aspirate via tracheostomy may inform care providers when determining the protective equipment required . The need for protocols to reduce risk of transmission of infection to nurses and other health care workers is evident .
CONCLUSION Critical care nurses and multidisciplinary teams often care for patients with a tracheostomy who are known or suspected to have COVID-19 . Appropriate care of these patients relies on safeguarding the health care team . The practices described in this review may greatly reduce risk of infectious transmission.