COVID-VU – ENT-UK national survey of flexible nasendoscopy in the upper aerodigestive tract amidst the COVID-19 pandemic
Abstract Background Flexible nasendoscopy (FNE) is an invaluable multi-disciplinary tool for upper aerodigestive tract (UADT) examination. During the COVID-19 pandemic concerns were raised that FNE had the potential of generating aerosols resulting in human cross-contamination when performed on SARS...
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-021-07416-x |
| _version_ | 1818203035938062336 |
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| author | Avgi Loizidou Taranjit Singh Tatla Ian Harvey Miriayi Aibibula Justin Roe Neeraj Sethi Anne G. M. Schilder |
| author_facet | Avgi Loizidou Taranjit Singh Tatla Ian Harvey Miriayi Aibibula Justin Roe Neeraj Sethi Anne G. M. Schilder |
| author_sort | Avgi Loizidou |
| collection | DOAJ |
| description | Abstract Background Flexible nasendoscopy (FNE) is an invaluable multi-disciplinary tool for upper aerodigestive tract (UADT) examination. During the COVID-19 pandemic concerns were raised that FNE had the potential of generating aerosols resulting in human cross-contamination when performed on SARS-COV2 carriers. In the UK, and other European countries, national guidelines were issued restricting FNE to essential cases. We surveyed ENT-UK members and Royal College of Speech and Language Therapists (RCSLT) members to determine the impact of the COVID-19 pandemic (first peak) on FNE practice in the UK. Methods An observational internet-based survey constructed in accordance to the CHERRIES checklist and setup in SurveyMonkey of FNE practice amongst UK-based ENT surgeons and speech and language therapists in community clinics, the outpatient department, inpatient wards, ICU, emergency department and operating theatres (through the NHS and private sector) prior to, during and following the first COVID-19 wave in the UK. Results 314 responses collected (24% response rate), 82% from ENT clinicians, 17% from SLTs and 1% from other allied healthcare professionals. Overall, there has been a large reduction in the volume and indications for FNE during the first peak of the COVID-19 pandemic with limited recovery by mid-August 2020. Cancer and airway assessments were impacted less. A wide range of FNE protocols influenced by local factors are reported, varying in endoscope preference, Personal Protective Equipment (PPE) and sterilization methods. Where dedicated Aerosol Generating Procedure (AGP) rooms were unavailable, clinicians resorted to window opening and variable room “down-time” between patients. Endoscope preference reflected availability and user familiarity, ENT trainees favoring the use of single-use video endoscopes. Conclusion Despite national guidance, local practice of FNE remains interrupted and highly variable in the UK. A collaborative inter-disciplinary approach is required to re-introduce FNE safely in volume across healthcare settings, re-establishing timely endoscopic diagnosis and pre-pandemic levels of patient care. |
| first_indexed | 2024-12-12T03:18:57Z |
| format | Article |
| id | doaj.art-3a254b19d42f4f0492ad389ceb91b704 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-12T03:18:57Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-3a254b19d42f4f0492ad389ceb91b7042022-12-22T00:40:13ZengBMCBMC Health Services Research1472-69632022-05-0122111110.1186/s12913-021-07416-xCOVID-VU – ENT-UK national survey of flexible nasendoscopy in the upper aerodigestive tract amidst the COVID-19 pandemicAvgi Loizidou0Taranjit Singh Tatla1Ian Harvey2Miriayi Aibibula3Justin Roe4Neeraj Sethi5Anne G. M. Schilder6Deptment of ENT-Head & Neck Surgery, London North West University Healthcare NHS TrustDeptment of ENT-Head & Neck Surgery, London North West University Healthcare NHS TrustSchool of Public Health, San Diego State UniversityAmbu Limited, Incubator 2, Alconbury Weald Enterprise CampusDepartment of Speech, Voice and Swallowing, The Royal Marsden NHS Foundation TrustDept of Otolaryngology-Head & Neck Surgery, Queens Medical Centre, Nottingham University Hospitals NHS TrustevidENT, Ear Institute, University College LondonAbstract Background Flexible nasendoscopy (FNE) is an invaluable multi-disciplinary tool for upper aerodigestive tract (UADT) examination. During the COVID-19 pandemic concerns were raised that FNE had the potential of generating aerosols resulting in human cross-contamination when performed on SARS-COV2 carriers. In the UK, and other European countries, national guidelines were issued restricting FNE to essential cases. We surveyed ENT-UK members and Royal College of Speech and Language Therapists (RCSLT) members to determine the impact of the COVID-19 pandemic (first peak) on FNE practice in the UK. Methods An observational internet-based survey constructed in accordance to the CHERRIES checklist and setup in SurveyMonkey of FNE practice amongst UK-based ENT surgeons and speech and language therapists in community clinics, the outpatient department, inpatient wards, ICU, emergency department and operating theatres (through the NHS and private sector) prior to, during and following the first COVID-19 wave in the UK. Results 314 responses collected (24% response rate), 82% from ENT clinicians, 17% from SLTs and 1% from other allied healthcare professionals. Overall, there has been a large reduction in the volume and indications for FNE during the first peak of the COVID-19 pandemic with limited recovery by mid-August 2020. Cancer and airway assessments were impacted less. A wide range of FNE protocols influenced by local factors are reported, varying in endoscope preference, Personal Protective Equipment (PPE) and sterilization methods. Where dedicated Aerosol Generating Procedure (AGP) rooms were unavailable, clinicians resorted to window opening and variable room “down-time” between patients. Endoscope preference reflected availability and user familiarity, ENT trainees favoring the use of single-use video endoscopes. Conclusion Despite national guidance, local practice of FNE remains interrupted and highly variable in the UK. A collaborative inter-disciplinary approach is required to re-introduce FNE safely in volume across healthcare settings, re-establishing timely endoscopic diagnosis and pre-pandemic levels of patient care.https://doi.org/10.1186/s12913-021-07416-xFlexible nasendoscopyCOVID-19Upper aerodigestive tractAerosol generating procedure |
| spellingShingle | Avgi Loizidou Taranjit Singh Tatla Ian Harvey Miriayi Aibibula Justin Roe Neeraj Sethi Anne G. M. Schilder COVID-VU – ENT-UK national survey of flexible nasendoscopy in the upper aerodigestive tract amidst the COVID-19 pandemic BMC Health Services Research Flexible nasendoscopy COVID-19 Upper aerodigestive tract Aerosol generating procedure |
| title | COVID-VU – ENT-UK national survey of flexible nasendoscopy in the upper aerodigestive tract amidst the COVID-19 pandemic |
| title_full | COVID-VU – ENT-UK national survey of flexible nasendoscopy in the upper aerodigestive tract amidst the COVID-19 pandemic |
| title_fullStr | COVID-VU – ENT-UK national survey of flexible nasendoscopy in the upper aerodigestive tract amidst the COVID-19 pandemic |
| title_full_unstemmed | COVID-VU – ENT-UK national survey of flexible nasendoscopy in the upper aerodigestive tract amidst the COVID-19 pandemic |
| title_short | COVID-VU – ENT-UK national survey of flexible nasendoscopy in the upper aerodigestive tract amidst the COVID-19 pandemic |
| title_sort | covid vu ent uk national survey of flexible nasendoscopy in the upper aerodigestive tract amidst the covid 19 pandemic |
| topic | Flexible nasendoscopy COVID-19 Upper aerodigestive tract Aerosol generating procedure |
| url | https://doi.org/10.1186/s12913-021-07416-x |
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