. 2020 Apr 27;42(6):1291–1296. doi: 10.1002/hed.26191

TABLE 1.

Technical and logistic considerations regarding tracheostomy

COVID‐19 status	Recommendations	Other considerations
Positive/PUI or unknown	Location: ICU preferred, negative pressure room PPE: N95 mask or PAPR, head covering, eye protection, gown, and two pairs of gloves	Limit number of providers in the room during the procedure Use of paralysis recommended to prevent coughing Clear and constant communication with anesthesia during the tracheostomy, holding ventilation when the ETT cuff is deflated and when the trachea is opened Avoid use of laryngotracheal topical anesthesia (aerosolizing)
Negative (one test 48‐72 h prior) or asymptomatic	Location: OR or ICU, negative pressure room PPE: N95 mask or PAPR, head covering, eye protection, gown, and two pairs of gloves

COVID‐19 status

Recommendations

Other considerations

Positive/PUI or unknown

Location: ICU preferred, negative pressure room

PPE: N95 mask or PAPR, head covering, eye protection, gown, and two pairs of gloves

Limit number of providers in the room during the procedure
Use of paralysis recommended to prevent coughing
Clear and constant communication with anesthesia during the tracheostomy, holding ventilation when the ETT cuff is deflated and when the trachea is opened
Avoid use of laryngotracheal topical anesthesia (aerosolizing)

Negative (one test 48‐72 h prior) or asymptomatic

Location: OR or ICU, negative pressure room

PPE: N95 mask or PAPR, head covering, eye protection, gown, and two pairs of gloves

Abbreviations: COVID‐19, coronavirus disease 2019; ETT, endotracheal tube; ICU, intensive care unit; OR, operating room; PAPR, powered air‐purifying respiratory; PUI, person under investigation.