ST. LOUIS — The team at Mercy Hospital St. Louis created a new operating “bubble” that allows surgeons to perform an open tracheostomy on patients with COVID-19, without having to move them to the operating room.
Tracheostomy surgeries are high risk because of the aerosolization that occurs when a breathing tube is inserted into the windpipe, according to a press release.
The procedure becomes necessary when COVID-19 patients spend a lot of time on a ventilator. It protects their vocal cords and makes it safer to wean them off breathing support when their condition improves, according to the release.
“We move the OR to the intensive care unit,” said Dr. Alison Gildehaus, medical director of trauma and acute care surgery at Mercy Hospital St. Louis. “Patients stay in their negative pressure, ICU rooms – removing the added risk of transport – and the surgery team comes to them. We limit the number of people in the room, thus conserving PPE, yet have added support right outside.”
The team uses ordinary materials available in the hospital to create a bubble-like environment that keeps the patient and surgical team safe during the procedure.
Dr. Gildehaus said they took the idea of the aerosol box, designed by a Taiwanese doctor, and built upon it.
The aerosol boxes are made of clear acrylic and lend a layer of protection to the medical team when they are placing a breathing tube through a patient’s mouth.
With the surgical bubble, the patient’s entire body is encased in a tarped bubble, protecting the patient while reducing the risk of exposure to the team.
The team performing the procedure includes an anesthesiologist, respiratory therapist, surgical technologist and two airway surgeons.
Click here to learn more about the procedure.
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