A Case Report of Tracheostomy for a Patient with COVID-19: How to Minimize Medical Staff and Patient Risks
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3346/jkms.2020.35.e263
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Seok Hwa YOUN
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Sun Young BAEK
			        		
			        		;
		        		
		        		
		        		
			        		Jiho YOON
			        		
			        		;
		        		
		        		
		        		
			        		Sung Soo HONG
			        		
			        		;
		        		
		        		
		        		
			        		Younghwan KIM
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Department of Surgery, National Medical Center, Seoul, Korea
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Case Report
 
        	
        	
            
            
            	- From:Journal of Korean Medical Science
	            		
	            		 2020;35(28):e263-
	            	
            	
 
            
            
            	- CountryRepublic of Korea
 
            
            
            	- Language:English
 
            
            
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		        	Abstract:
			       	
			       		
				        
				        	 Coronavirus disease was first reported in December 2019, and the World Health Organization declared it as a pandemic on March 11, 2020. The virus is known to attack various vital organs, including the respiratory system. Patients sometimes require positive pressure ventilation and tracheostomy. Because tracheostomy is a droplet-spreading procedure, medical staff should protect themselves against the risk of transmission of this contagious viral disease. In our case, we performed tracheostomy for a 70-year-old man with coronavirus disease 2019 (COVID-19) who had required more oxygen with gradual weakness of respiratory muscle to maintain his arterial oxygen saturation. We focused on the risks of the medical staffs and patients, and minimized them at the same time using temporary balloon over-inflation, pre-operative adjustment of endotracheal tube position, and attachment of a transparent film dressing to the surgical field without stopping the ventilator while following routine safety measures. Fourteen days after the tracheostomy, all participating medical staff members were healthy and asymptomatic. The patient was discharged 105 days after the COVID-19 diagnosis.