The nasal tent: an adjuvant for performing endoscopic endonasal surgery in the Covid era and beyond
- PDF / 669,719 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 60 Downloads / 159 Views
HOW I DO IT
The nasal tent: an adjuvant for performing endoscopic endonasal surgery in the Covid era and beyond S. H. Maharaj1 Received: 6 June 2020 / Accepted: 16 June 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To propose a cost-effective reproducible barrier method to safely perform endoscopic endonasal surgery during the Covid-19 pandemic. Methods This manuscript highlights the use of a clear, cost-effective disposable plastic sheet that is draped as a tent over the operating area to contain aerolization of particles. This is then connected to a suction to remove airborne particles and thus reduce transmission of the virus. Conclusion The use of a nasal tent is a simple and affordable method to limit particle spread during high-risk aerolisation procedures during the Covid era and beyond. Keywords Nasal tent; endoscopic sinus surgery · Covid-19
Background The advent of the Covid-19 pandemic has disrupted healthcare systems and surgical procedures throughout the world. Coronaviruses are approximately 0.125 µm in size and are frequently carried in respiratory droplets [1]. The study demonstrates that COVID-19 can remain viable and infectious for hours in aerosolized materials and for days on surfaces [2]. Due to the high risk of viral aerolisation during procedures such as endoscopic sinus surgery, a plethora of cases have been postponed or cancelled [3]. However, it is not feasible to continue in this manner, as the duration of the pandemic is hard to predict. There may also be further global viral pandemics in future and thus the otorhinolaryngology community has to now adapt to the new normal. Mitigation strategies have included cold surgical instrumentation, negative pressure theatres and the use of the microdebrider [4]. The gold standard would be to create two self-contained surgical environments (one for the aneathetized patient and
* S. H. Maharaj [email protected] 1
Department of Otorhinolaryngology, University of the Witwatersrand, Johannesburg, South Africa
another for the theatre team) that can easily interact with each other and not allow cross contamination. The use of Personal protective equipment (PPE) creates a barrier that protects the health care worker, however, it would be easier just to isolate the patient within a threedimensional surgical field that would trap and remove aerosolized particles [5]. We propose the use of a simple clear isolation plastic sheet (160 × 200 cm) nasal tent to limit aerolization during these procedures. The cost of such a sheet varies from 4 to 8 US dollars and is quite readily available in most centres throughout the world.
Description of the technique The patient is intubated with a cuffed endotracheal tube using PPE and the video laryngoscope. The patient is positioned, a throat pack inserted and draped. An operating tray is positioned at the cranial end of the bed 30 cm above the patients head (Fig. 1). Two openings are left for the surgeons hands and the scrub nurse. These are inserted under the t
Data Loading...
