Table 2.

Special considerations for PEG‐tube placement in COVID‐19 patients

Factors	Comments
Appropriate selection	Patient selection is critical Goals and objectives of the procedure should be based on the indication and contraindications
Indications	Tracheostomy with a need for prolonged enteral nutrition Inability to tolerate NJ/OG tube (displacement/ need for repeated imaging/ sinusitis/ oral‐pharyngeal ulceration) Expedite discharge planning to a long‐term facility
Contraindications	Cautious approach in patients on full‐dose/therapeutic anticoagulation with higher bleeding risk, low chances of survival, and severe abdominal wound infection
Multidisciplinary approach	Discussion between primary, procedural, and palliative teams and patient/family about the risks and benefits
Decrease movement	Patients movement should be minimized whenever possible
Cluster method	Tracheotomy and PEG‐tube placement same day if possible
Procedure specifics	Minimal use of staff, strict PPE use, and negative pressure rooms based on institutional policies and availability Use of barrier protection (isolation drapes/C‐cube/endoprotector) to decrease aerosolization risk

Percutaneous gastrostomy (PEG) tube placement. COVID‐19, coronavirus disease 2019; NJ, Nasogastric; OG, Orogastric; PPE, personal protective equipment.