Covid-19 and ENT practice: Our experience: ENT outpatient department, ward and operating room management during the SARS-CoV-2 pandemic

Objectives: The current study aims at assessing the effectiveness of the guidelines set up by our clinic for the protection of patients and staff which enabled us to proceed with urgent and oncological surgery after the outbreak of the Covid-19 pandemic. Material and methods: Our ENT department devised specific equipment to be worn by the staff for personal protection when dealing with Covid-19 patients both in aerosol generating and non-generating procedures. Moreover, restrictive measures were enforced both for the outpatient department and for the ward where only urgent practices were carried out and visitors were not allowed, while non-urgent elective surgery was postponed. A codified scheme was followed to perform tracheostomy procedure in Covid-19 positive testing patients on the part of 3 specific teams of 2 surgeons each, while the resident educational program was reorganized to limit the spread of the infection. Results: In about a couple of months (from March 8th to May 3rd) a relevant amount of medical tests and surgical procedures were carried out on non COVID-19 patients and a certain number of tracheostomies were performed on COVID-19 patients. Consequently, all the ENT personnel were checked and found negative. Also, all the patients in the ward were swab tested and chest X-rayed, only one had a positive outcome and was adequately handled and treated. Conclusion: Our ENT guidelines regarding personal protection equipment and multiple simultaneous diagnostic procedures have proved to be an essential instrument for the management of patients with both known and unknown COVID-19 status.