Survey of UPMC Tracheostomy Providers
A brief survey focusing on tracheostomy practices during March and April 2020 was completed by Otolaryngologists, General Surgeons, and Thoracic Surgeons at the UPMC Oakland campus. Providers were asked to respond how often certain practices were being used during the procedure: always, usually, about half the time, seldom, or never (Figure 3). In addition, providers were asked to provide suggestions for tracheostomy time-out design especially with regards to key safety measures. A total of 15 providers responded of which 9 had performed tracheostomies in this timeframe (6 Otolaryngologists, 2 General Surgeons, and 1 Thoracic Surgeon). Each provider performed an average of 3 tracheostomies (range: 1-6). None of the patients had confirmed COVID-19 infection although four patients were under investigation at time of procedure. Most providers (77%; 7/9) performed open tracheostomies compared to percutaneous approach. On average, two members of the surgical team were present for the procedure (range: 1-3). Only one of the providers noted using a negative pressure room for the tracheostomy. Most providers reported always using the following practices: wearing an N95 mask (66%, 6/9), patient paralysis (66%, 6/9), holding ventilation with open respiratory circuit (77%, 7/9), and using cuffed tracheostomy tube (88%, 8/9). Only three providers noted waiting for COVID-19 status before performing the tracheostomy tube change. Providers frequently performed the trach change between post-op days 5 to 10 (38%, 3/8) or after 10 days (38%, 3/8); only 2 providers performed the trach change on post-op day 5.