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. 2020 Jun 5;108:104844. doi: 10.1016/j.oraloncology.2020.104844

Table 2.

Tracheostomy care guidelines. HME (Humidity-Moisture Exchange), HEPA ((High Efficiency Particulate Air), NE (Not specified).

Country Last Update COVID-19 Status Airway protection for patients Tracheal tube changes by healthcare workers Voice Prosthesis changes Other
Spanish Society of Otorhinolaryngology – Head & Neck Surgery.
(Spain) [30]
March 26, 2020 COVID-19 Negative




COVID-19 Suspected or Positive.
HME filter, surgical mask over the tracheal stoma when is indicated or HEPA filter.


HME filter or HEPA filter.
Basic PPE (Gloves, Goggles, Surgical mask or FFP2, gown)


Full PPE.
Basic PPE




Full PPE
No




Aspiration on close suction system.
French Society of Otorhinolaryngology - Head & Neck Surgery. (France) [25] April 9, 2020 Any patient should be considered as potentially infected NE Apron or surgical gown.

Forehead protection to protect skin exposure.

Gloves.

Goggles.

FFP2 – N95 Mask.
NE If the patient is ventilated on the tracheostomy cannula, ask the
anesthesiologist to sedate the patient and perform a neuromuscular block to
reduce any risk of coughing during the change of the cannula.