Clinical evidence based review and recommendations of aerosol generating medical procedures in otolaryngology - head and neck surgery during the COVID-19 pandemic.
Aerosols
/ adverse effects
Betacoronavirus
/ isolation & purification
COVID-19
Coronavirus Infections
/ transmission
Humans
Infection Control
/ standards
Infectious Disease Transmission, Patient-to-Professional
/ prevention & control
Otorhinolaryngologic Diseases
/ complications
Otorhinolaryngologic Surgical Procedures
/ adverse effects
Pandemics
Pneumonia, Viral
/ transmission
Practice Guidelines as Topic
SARS-CoV-2
Aerosol
Aerosolization
COVID-19
Guideline
Review
Journal
Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale
ISSN: 1916-0216
Titre abrégé: J Otolaryngol Head Neck Surg
Pays: England
ID NLM: 101479544
Informations de publication
Date de publication:
06 May 2020
06 May 2020
Historique:
received:
15
04
2020
accepted:
28
04
2020
entrez:
8
5
2020
pubmed:
8
5
2020
medline:
10
5
2020
Statut:
epublish
Résumé
Aerosol generating medical procedures (AGMPs) present risks to health care workers (HCW) due to airborne transmission of pathogens. During the COVID-19 pandemic, it is essential for HCWs to recognize which procedures are potentially aerosolizing so that appropriate infection prevention precautions can be taken. The aim of this literature review was to identify potential AGMPs in Otolaryngology - Head and Neck Surgery and provide evidence-based recommendations. A literature search was performed on Medline, Embase and Cochrane Review databases up to April 3, 2020. All titles and abstracts of retrieved studies were evaluated and all studies mentioning potential AGMPs were included for formal review. Full text of included studies were assessed by two reviewers and the quality of the studies was evaluated. Ten categories of potential AGMPs were developed and recommendations were provided for each category. Direct evidence indicates that CO2 laser ablation, the use of high-speed rotating devices, electrocautery and endotracheal suctioning are AGMPs. Indirect evidence indicates that tracheostomy should be considered as potential AGMPs. Nasal endoscopy and nasal packing/epistaxis management can result in droplet transmission, but it is unknown if these procedures also carry the risk of airborne transmission. During the COVID-19 pandemic, special care should be taken when CO2 lasers, electrocautery and high-speed rotating devices are used in potentially infected tissue. Tracheal procedures like tracheostomy and endotracheal suctioning can also result in airborne transmission via small virus containing aerosols.
Sections du résumé
BACKGROUND
BACKGROUND
Aerosol generating medical procedures (AGMPs) present risks to health care workers (HCW) due to airborne transmission of pathogens. During the COVID-19 pandemic, it is essential for HCWs to recognize which procedures are potentially aerosolizing so that appropriate infection prevention precautions can be taken. The aim of this literature review was to identify potential AGMPs in Otolaryngology - Head and Neck Surgery and provide evidence-based recommendations.
METHODS
METHODS
A literature search was performed on Medline, Embase and Cochrane Review databases up to April 3, 2020. All titles and abstracts of retrieved studies were evaluated and all studies mentioning potential AGMPs were included for formal review. Full text of included studies were assessed by two reviewers and the quality of the studies was evaluated. Ten categories of potential AGMPs were developed and recommendations were provided for each category.
RESULTS
RESULTS
Direct evidence indicates that CO2 laser ablation, the use of high-speed rotating devices, electrocautery and endotracheal suctioning are AGMPs. Indirect evidence indicates that tracheostomy should be considered as potential AGMPs. Nasal endoscopy and nasal packing/epistaxis management can result in droplet transmission, but it is unknown if these procedures also carry the risk of airborne transmission.
CONCLUSIONS
CONCLUSIONS
During the COVID-19 pandemic, special care should be taken when CO2 lasers, electrocautery and high-speed rotating devices are used in potentially infected tissue. Tracheal procedures like tracheostomy and endotracheal suctioning can also result in airborne transmission via small virus containing aerosols.
Identifiants
pubmed: 32375884
doi: 10.1186/s40463-020-00425-6
pii: 10.1186/s40463-020-00425-6
pmc: PMC7202463
doi:
Substances chimiques
Aerosols
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
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