Publication: Pragmatic recommendations for tracheostomy, discharge, and rehabilitation measures in hospitalized patients recovering from severe COVID-19 in low- And middle-income countries
Issued Date
2021-03-01
Resource Type
ISSN
14761645
00029637
00029637
Other identifier(s)
2-s2.0-85103291695
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
American Journal of Tropical Medicine and Hygiene. Vol.104, No.3 (2021), 110-119
Suggested Citation
T. Eoin West, Marcus J. Schultz, Hanan Y. Ahmed, Gentle S. Shrestha, Alfred Papali Pragmatic recommendations for tracheostomy, discharge, and rehabilitation measures in hospitalized patients recovering from severe COVID-19 in low- And middle-income countries. American Journal of Tropical Medicine and Hygiene. Vol.104, No.3 (2021), 110-119. doi:10.4269/ajtmh.20-1173 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/77309
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Pragmatic recommendations for tracheostomy, discharge, and rehabilitation measures in hospitalized patients recovering from severe COVID-19 in low- And middle-income countries
Abstract
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.