Discussion
Tracheostomies are a common surgical procedure performed by otolaryngologists in both the emergent and elective setting. Additionally, there may be some expanding indications in the COVID-19 patient population. As COVID-19 patients wean off the ventilator, some may be at high risk for requiring non-invasive ventilation or reintubation. Both instances have been noted to be aerosol-generating events, and should be avoided when possible. Ventilation using a tracheostomy has many potential benefits including providing closed-circuit respiratory support, allowing for decreased sedation, and requiring less intensive nursing care (6). Discussion between intensive care and otolaryngology teams should take place to decide whether tracheostomy is indicated in this patient population. In patients testing positive for COVID-19, this summary of recommendations serves as a guideline along with institutional protocols.