The extremely contagious nature of COVID-19 during certain procedures led a Mercy team to create a new operating “bubble” that allows surgeons to perform an open tracheostomy on the sickest patients without moving them to the operating room.
Tracheostomy is high risk for the surgery team because of the aerosolization that occurs when a breathing tube is inserted into the windpipe. The procedure becomes necessary when very sick COVID-19 patients spend prolonged time on a ventilator. It protects their vocal cords and makes it safer to wean them from breathing support when their condition improves.
“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.”