Pragmatic recommendations for tracheostomy, discharge, and rehabilitation measures in hospitalized patients recovering from severe COVID-19 in low- and middle-income countries
New studies of COVID-19 are constantly updating best practices in clinical care. However, research mainly originates in resource-rich settings in high-income countries. Often, it is impractical to apply recommendations based on these investigations to resource-constrained settings in low- and middle...
| Main Authors: | , , , , |
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| Other Authors: | |
| Format: | Journal article |
| Language: | English |
| Published: |
American Society for Tropical Medicine and Hygiene
2021
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| _version_ | 1797104348999712768 |
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| author | West, TE Schultz, MJ Ahmed, HY Shrestha, GS Papali, A |
| author2 | COVID–LMIC Task Force |
| author_facet | COVID–LMIC Task Force West, TE Schultz, MJ Ahmed, HY Shrestha, GS Papali, A |
| author_sort | West, TE |
| collection | OXFORD |
| description | New studies of COVID-19 are constantly updating best practices in clinical care. However, research mainly originates in resource-rich settings in high-income countries. Often, it is impractical to apply recommendations based on these investigations to resource-constrained settings in low- and middle-income countries (LMICs). We report on a set of pragmatic recommendations for tracheostomy, discharge, and rehabilitation measures in hospitalized patients recovering from severe COVID-19 in LMICs. We recommend that tracheostomy be performed in a negative pressure room or negative pressure operating room, if possible, and otherwise in a single room with a closed door. We recommend using the technique that is most familiar to the institution and that can be conducted most safely. We recommend using fit-tested enhanced personal protection equipment, with the fewest people required, and incorporating strategies to minimize aerosolization of the virus. For recovering patients, we suggest following local, regional, or national hospital discharge guidelines. If these are lacking, we suggest deisolation and hospital discharge using symptom-based criteria, rather than with testing. We likewise suggest taking into consideration the capability of primary caregivers to provide the necessary care to meet the psychological, physical, and neurocognitive needs of the patient. |
| first_indexed | 2024-03-07T06:32:33Z |
| format | Journal article |
| id | oxford-uuid:f68348df-ed0e-42fb-b825-53e7df431cb2 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T06:32:33Z |
| publishDate | 2021 |
| publisher | American Society for Tropical Medicine and Hygiene |
| record_format | dspace |
| spelling | oxford-uuid:f68348df-ed0e-42fb-b825-53e7df431cb22022-03-27T12:35:35ZPragmatic recommendations for tracheostomy, discharge, and rehabilitation measures in hospitalized patients recovering from severe COVID-19 in low- and middle-income countriesJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f68348df-ed0e-42fb-b825-53e7df431cb2EnglishSymplectic ElementsAmerican Society for Tropical Medicine and Hygiene2021West, TESchultz, MJAhmed, HYShrestha, GSPapali, ACOVID–LMIC Task ForceMahidol-Oxford Research Unit (MORU)New studies of COVID-19 are constantly updating best practices in clinical care. However, research mainly originates in resource-rich settings in high-income countries. Often, it is impractical to apply recommendations based on these investigations to resource-constrained settings in low- and middle-income countries (LMICs). We report on a set of pragmatic recommendations for tracheostomy, discharge, and rehabilitation measures in hospitalized patients recovering from severe COVID-19 in LMICs. We recommend that tracheostomy be performed in a negative pressure room or negative pressure operating room, if possible, and otherwise in a single room with a closed door. We recommend using the technique that is most familiar to the institution and that can be conducted most safely. We recommend using fit-tested enhanced personal protection equipment, with the fewest people required, and incorporating strategies to minimize aerosolization of the virus. For recovering patients, we suggest following local, regional, or national hospital discharge guidelines. If these are lacking, we suggest deisolation and hospital discharge using symptom-based criteria, rather than with testing. We likewise suggest taking into consideration the capability of primary caregivers to provide the necessary care to meet the psychological, physical, and neurocognitive needs of the patient. |
| spellingShingle | West, TE Schultz, MJ Ahmed, HY Shrestha, GS Papali, A Pragmatic recommendations for tracheostomy, discharge, and rehabilitation measures in hospitalized patients recovering from severe COVID-19 in low- and middle-income countries |
| title | Pragmatic recommendations for tracheostomy, discharge, and rehabilitation measures in hospitalized patients recovering from severe COVID-19 in low- and middle-income countries |
| title_full | Pragmatic recommendations for tracheostomy, discharge, and rehabilitation measures in hospitalized patients recovering from severe COVID-19 in low- and middle-income countries |
| title_fullStr | Pragmatic recommendations for tracheostomy, discharge, and rehabilitation measures in hospitalized patients recovering from severe COVID-19 in low- and middle-income countries |
| title_full_unstemmed | Pragmatic recommendations for tracheostomy, discharge, and rehabilitation measures in hospitalized patients recovering from severe COVID-19 in low- and middle-income countries |
| title_short | Pragmatic recommendations for tracheostomy, discharge, and rehabilitation measures in hospitalized patients recovering from severe COVID-19 in low- and middle-income countries |
| title_sort | pragmatic recommendations for tracheostomy discharge and rehabilitation measures in hospitalized patients recovering from severe covid 19 in low and middle income countries |
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