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Pediatric E.N.T. emergencies during COVID-19 pandemic: our experience
Anand Palas1, Jayman Raval1, R G Aiyer1
1Department of E.N.T. and Head-Neck Surgery, Baroda Medical College and S.S.G. Hospital, Vadodara, Gujarat India.
Insights
The COVID-19 pandemic impacted pediatric Ear, Nose, and Throat (ENT) emergency care. Recommendations include prioritizing emergency procedures and using personal protective equipment to minimize healthcare worker infection risk.
Area of Science:
- Otolaryngology
- Pediatric Emergency Medicine
- Infectious Disease Control
Background:
- The COVID-19 pandemic presented significant challenges in managing pediatric emergencies within Ear, Nose, and Throat (ENT) settings.
- Healthcare providers needed to adapt protocols to ensure patient safety and minimize infection transmission risks.
Purpose of the Study:
- To analyze the effects of the COVID-19 pandemic on the management of pediatric ENT emergencies.
- To provide evidence-based recommendations for managing these emergencies during a pandemic.
Main Methods:
- A retrospective study included 29 pediatric patients (1 day to 13 years) requiring urgent ENT interventions during the COVID-19 pandemic.
- Diagnostic procedures like X-ray, HRCT neck/chest with virtual bronchoscopy, and RT-PCR for COVID-19 were selectively employed based on patient stability.
- Strict adherence to personal protective equipment (PPE) protocols was maintained.
Main Results:
- Interventions were performed for foreign body inhalation, ingestion, insertion, and compromised airways requiring endotracheal intubation.
- Radiological investigations and COVID-19 screening were contingent on patient clinical stability.
- The study highlights the successful management of critical pediatric ENT emergencies under pandemic conditions.
Conclusions:
- Recommendations emphasize performing only essential emergency procedures during a pandemic.
- Consistent use of PPE, appropriate preoperative diagnostics, and modifications in operating room, anesthesia, and surgical techniques are crucial.
- These measures are vital for minimizing aerosol generation and reducing infection transmission risks to healthcare workers.
Abstract:
Our aim is to analyze effect of covid-19 pandemic in management of pediatric emergencies in E.N.T. and to provide recommendations for management of pediatric emergencies in E.N.T. during pandemic. In this retrospective study we included emergency pediatric cases required early intervention during covid-19 pandemic. Pre operative radiological investigation x-ray was done in all aero digestive foreign body patients. Pre operative HRCT neck and chest with virtual bronchoscopy in foreign body inhalation & compromised airway patients was done only in cases where patient's clinical condition was stable. Similarly RT PCR for covid-19 screening done only in cases where patient's clinical condition was stable. Adequate personal protective equipment was used during all the procedures. Total 29 Pediatric patients age ranging from 1 day to 13 years underwent procedures due to history of foreign body inhalation; ingestion, insertion and compromised airway in form of immediate endotracheal intubation were included. Comprehensively we recommend intervention only in emergency procedures during pandemic, use of personal protective equipment during all procedures, preoperative investigations for diagnosis and modifications in operation theatre, anesthesia and surgical techniques to reduce aerosols generation will minimize risk of infection transmission to health care workers.
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