Abstract:
To outline a set of recommendations on the management of pediatric cases who requiring airway surgery in the context of COVID 19 pandemic. A set of recommendations have been prepared based on National and International published scientific literature and recent updates on COVID 19. These has been implemented in our tertiary care centre. Due to the evolving nature of COVID 19 and existing knowledge gaps, these recommendations may have to be revised periodically. The incidence of COVID 19 is very low (1-5%) in the pediatric age group with relatively good prognosis. Pediatric airway surgeries should be restricted to emergency cases only. The decision of postponement of the surgical cases should be taken by the team of senior pediatric airway surgeons. Flexible laryngoscopy should be avoided. Foreign body cases should undergo a computed tomography scan to avoid diagnostic bronchoscopies. All the measures should be taken to prevent direct contact of aerosol so powered instruments should not be used unless mandatory. Protective draping method should be adopted to prevent aerosol exposure. As paediatric airway surgeries are aerosol generating procedure where the risk of contracting COVID 19 by the surgeons and support staff is very high, we suggest recommendations to prevent the contact with infected aerosol. We assure these recommendations are easy to follow and can impact good quality outcome during this pandemic crisis.
摘要:
概述在COVID19大流行背景下需要进行气道手术的儿科病例的管理建议。根据国家和国际发表的科学文献以及最近关于COVID19的最新情况,制定了一套建议。这些措施已在我们的三级护理中心实施。由于COVID19的不断演变的性质和现有的知识差距,这些建议可能需要定期修订。COVID19的发病率在儿童年龄组中非常低(1-5%),预后相对良好。小儿气道手术应仅限于紧急情况。推迟手术病例的决定应由高级儿科气道外科医生团队决定。应避免柔性喉镜检查。异物病例应进行计算机断层扫描,以避免诊断支气管镜检查。应采取所有措施以防止直接接触气溶胶,因此除非强制性,否则不得使用动力仪器。应采用保护性悬垂法防止气溶胶暴露。由于儿科气道手术是气溶胶生成程序,外科医生和支持人员感染COVID19的风险非常高,我们建议防止接触受感染的气雾剂。我们保证这些建议很容易遵循,并且可以在这场大流行危机中影响高质量的结果。