Related Experiment Video
Updated: Nov 25, 2025
Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
YO-IFOS Guidelines for Pediatric ENT Surgery during COVID-19: An Overview of Recommendations
Taseer Din1, Tagwa Abdalla2, Carlos Chiesa-Estomba3,4
1Division of Otolaryngology, University of Cape Town and Red Cross Children's Hospital, Cape Town, South Africa.
Insights
This review synthesizes global pediatric ENT COVID-19 guidelines to recommend surgical practices during the pandemic. Key recommendations focus on urgent surgeries, airway obstruction, cancer diagnosis, and sepsis management.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Infectious Disease Epidemiology
Background:
- The COVID-19 pandemic significantly impacted global healthcare, necessitating rapid adaptation of clinical practices.
- Pediatric Ear, Nose, and Throat (ENT) surgical services faced unique challenges due to the vulnerability of pediatric patients and the nature of aerosol-generating procedures.
Purpose of the Study:
- To conduct a comprehensive literature review of pediatric ENT COVID-19 guidelines worldwide.
- To establish evidence-based recommendations for pediatric ENT surgical practice during the pandemic.
Main Methods:
- A systematic literature review was performed using PubMed, Medline, Google, and Google Scholar.
- Included resources were published papers and national/international pediatric ENT society guidelines identified between April 26-30, 2020.
Main Results:
- Fourteen guidelines met inclusion criteria; recommendations were graded based on consensus.
- Highly recommended: defining urgent/emergent pediatric ENT surgeries, managing acute airway obstruction, diagnosing suspected cancers promptly, and surgical intervention for sepsis.
- Other key findings included senior surgeon involvement, preference for open over endoscopic approaches, and avoidance of aerosol-generating instruments.
Conclusions:
- The COVID-19 pandemic necessitates a re-evaluation of pediatric ENT surgical practices.
- Developing comprehensive, evidence-based recommendations is crucial for guiding pediatric ENT surgical care in the evolving COVID-19 era.
Objective/Hypothesis:
To review the literature on pediatric ENT COVID-19 guidelines worldwide, in particular, surgical practice during the pandemic, and to establish a comprehensive set of recommendations.
Study Design:
Review.
Methods:
A comprehensive literature review through an independent electronic search of the COVID-19 pandemic in PubMed, Medline, Google, and Google Scholar was performed on April 26-30, 2020. Resources identified comprised of published papers, national and international pediatric ENT society guidelines.
Results:
Fourteen guidelines fit the inclusion criteria. Key statements were formulated and graded: 1) Strong recommendation (reported by 9 or more/14); 2) Fair recommendation (7-8/14); 3) Weak recommendation (5-6/14); and 4) Expert opinion (2-4/14). Any single source suggestion was included as a comment. Highly scored recommendations included definition of urgent/emergent cases that required surgery; surgery for acute airway obstruction; prompt diagnosis of suspected cancer; and surgical intervention for sepsis following initial first-line medical management. Other well scored recommendations included senior faculty to perform the surgery; the use of open approaches rather than endoscopic ones; and avoidance of powered instruments that would aerosolize virus-loaded tissue. A tracheostomy should be performed on a case by case basis where key technical modifications become necessary.
Conclusions:
The COVID-19 pandemic will have a profound short and long-term impact on pediatric ENT practice. During this rapidly evolving climate, guidelines have been based on local practice and expert opinion. Until evidence-based practice in the COVID era is established, a comprehensive set of recommendations for pediatric ENT surgical practice based on a review of currently available literature and guidelines, is therefore, appropriate. Laryngoscope, 131:1876-1883, 2021.
More Related Videos
Related Concept Videos
01:26Tonsillitis II: Management
01:25Suctioning the Oropharyngeal Airway
After assembling the equipment, the nurse should practice hand hygiene and don appropriate PPE according to infection control guidelines to avoid the...
01:25Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
01:16Tracheostomy Care I: Pre-procedural Steps
Required Equipment
The equipment necessary for tracheostomy care includes:
01:23Tracheostomy Suctioning II: Procedure
01:26Tracheostomy Suctioning I: Pre-Procedural Steps
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...