From the classroom to the emergency room, O.R and beyond. You're joining Trauma ICU Rounds with your

host, Dr. Dennis Kim. Hey there, thanks for joining me on trauma ICU rounds. In our first rapid rounds,

we're discussing tracheostomies during the current COVID-19 pandemic. Given our recent episode on tracheostomies as well as what seems to be an ever-increasing

number of publications on this specific topic, pretty much on a daily basis, the timing

seems about right to discuss a few issues related to the when and how to perform a trache in

a patient with confirmed or previously

treated COVID-19. The format of rapid rounds is simple. I'd like to review with you one

clinically controversial or hot topic, which similar to other rounds is selected by you or on

the basis of recent developments in the surgical literature in under 10 minutes.

And to do this, rounds will be focused around one or two key questions or areas of concern as it relates to said topic.

Today's rapid rounds are informed by two recent articles in the trauma critical care literature,

one published in Trauma Surgery, Acute Care Open, and the other in the

Journal of Trauma and Acute Care Surgery. And the links to these articles can be found in the show notes

at TraumaicU Round.com. So we have two questions that we're going to discuss today, and the first

question is, when should we perform a

tracheosomy in COVID-19 patients? Now, in episode 8, we discussed several general considerations

when it comes to performing a trache in critically ill patients requiring prolonged mechanical

ventilation, but when it comes to patients with COVID-19, we're faced with a whole host of other issues

as they relate to the indications and timing of tracheostomy.

So why are we so fixated on timing?

Well, a lot of it comes down to, legitimately so, the significant risk of viral exposure to

health care workers and surgeons, anesthetists, nurses, and scrub techs, as well as

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