A discussion on strategic considerations, effective safety measures and procedural deliberations in otorhinolaryngology practice and surgery during COVID-19: an integrative approach

Authors

  • Sharad Hernot Department of ENT and Head and Neck Surgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India
  • Apoorva Kumar Pandey Department of ENT and Head and Neck Surgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India
  • Madhuri Kaintura Department of ENT and Head and Neck Surgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India
  • Tripti Maithani Department of ENT and Head and Neck Surgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India
  • Aparna Bhardwaj Department of Pathology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India
  • Ajaz Ul Haq Department of ENT and Head and Neck Surgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India
  • Fatma Anjum Department of ENT and Head and Neck Surgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India
  • Akanksha Bisht Department of ENT and Head and Neck Surgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20211187

Keywords:

COVID-19 pandemic, Coronavirus 19, SARS CoV-2, Otorhinolaryngology, Surgery, Outpatient department, Safety recommendations, RT-PCR

Abstract

Background: Coronavirus disease of 2019 (COVID-19) has made an imperishable haunting mark worldwide, and has changed in many aspects the way medicine had been practiced till now. This study is intended to highlight the approach that was followed in the department of ear, nose, and throat (ENT) learning from the existing available guidelines to provide safe routine and emergency ENT care to all the patients irrespective of the COVID status. Objectives of the study were to highlight the changes, challenges, triage and safety recommendations associated with patient management during the ongoing pandemic.

Methods: This study conducted between 25th March 2020 to 15th September 2020 constitutes of following points covering various aspects of patient management such as education about personal protective equipment, the 3-station triage system starting from the patient’s entry in the hospital, general working and precautions at the ENT outpatient department (OPD) registration counter, medical consultation with otorhinolaryngologist in OPD or in ER, general precautions in endoscopy room/voice lab, and operation theatre, patient transport, and postoperative care.  

Results: A total of 8930 patients were seen from 25th March 2020 to 15th September 2020. 7885 patients were seen in ENT outpatient department, 561 in emergency room, and 484 patients were seen as referrals sent from other departments. 297 patients were advised admission for various surgical procedures whereas 22 patients were admitted for conservative management.

Conclusions: Through this study, we suggest a paradigm consisting of safety and triage recommendations to be followed while dealing with patients in a way to minimise the cross transmission of virus.

Author Biographies

Sharad Hernot, Department of ENT and Head and Neck Surgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India

Assistant Professor

Department of ENT, and Head and Neck Surgery

 

Apoorva Kumar Pandey, Department of ENT and Head and Neck Surgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India

Professor

Department of ENT, and Head and Neck Surgery

Madhuri Kaintura, Department of ENT and Head and Neck Surgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India

Senior Resident

Department of ENT, and Head and Neck Surgery

Aparna Bhardwaj, Department of Pathology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India

Professor

Department of Pathology

Ajaz Ul Haq, Department of ENT and Head and Neck Surgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India

Assistant Professor

Department of ENT, and Head and Neck Surgery

Fatma Anjum, Department of ENT and Head and Neck Surgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India

Junior Resident

Department of ENT, and Head and Neck Surgery

Akanksha Bisht, Department of ENT and Head and Neck Surgery, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, Uttarakhand, India

Junior Resident

Department of ENT, and Head and Neck Surgery

References

Givi B, Schiff BA, Chinn SB, Clayburgh D, Iyer NG, Jalisi S, et al. Safety recommendations for evaluation and surgery of the head and neck during the COVID-19 pandemic. JAMA Otolaryngol Head Neck Surg. 2020;146:579-84.

World health Organisation. WHO Coronavirus disease (COVID-19) dashboard. 2020. Available at: https://covid19.who.int/. Accessed on 04 October 2020.

Ministry of Health and family welfare. Mohfw-Home. Mohfw.gov.in. 2020. Available at: https://www.mohfw.gov.in/. Accessed on 04 October 2020.

Vinh DB, Zhao X, Kiong KL, Guo T, Jozaghi Y, Yao C, et al. Overview of COVID-19 testing and implications for otolaryngologists. Head Neck. 2020;42:1629-33.

Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses. J Adv Res. 2020;24:91-8.

Yan F, Nguyen SA. Head and neck cancer: high-risk population for COVID-19. Head Neck. 2020;42:1150-2.

Yan F, Rauscher E, Hollinger A, Caputo MA, Ready J, Fakhry C, et al. The role of head and neck cancer advocacy organizations during the COVID-19 pandemic. Head Neck. 2020.

Lavinsky J, Kosugi EM, Baptistella E, Roithmann R, Dolci E, Ribeiro TK, et al. An update on COVID-19 for the otorhinolaryngologist- a Brazilian association of Otolaryngology and cervicofacial surgery (ABORL-CCF) position statement. Braz J Otorhinolaryngol. 2020;86:273-80.

World health Organization. Modes of Transmission of Virus Causing COVID-19: Implications for IPC Precaution Recommendations. Available at: https://www.who.int/news-room/commentaries/ detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations. Accessed on 02 October 2020.

World health Organization. Infection prevention and control of epidemic-and pandemic prone acute respiratory infections in health care. 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/ infection-control/control-recommendations.html. Accessed on 02 October 2020.

Guo ZD, Wang ZY, Zhang SF. Aerosol and surface distribution of severe acute respiratory syndrome coronavirus 2 in hospital wards, Wuhan, China, 2020. Emerg Infect Dis. 2020;26(7).

Bourouiba L. A sneeze. N Engl J Med. 2016;375:15.

Bourouiba L. Turbulent gas clouds and respiratory pathogen emissions. JAMA. 2020;323:1837-8.

Wang D, Hu B, Hu C. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020;323:1061-9.

Guan WJ, Ni ZY, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382:1708-20.

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Published

2021-03-24

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Section

Original Research Articles