Criteria for transferring a tracheosomised patient to a COVID-19 ward
The consideration to transfer a patient from critical care to a COVID-19 ward which is equipped to care facilitate tracheostomy ventilation weaning should prompt a discussion between the ward team and the critical care team. Patients should meet the locally agreed inclusion criteria, for example:
- Resolution of multi-organ failure
- Tracheostomy in situ
- Awake and alert
- Decision on re-escalation has been made
In addition, they should also have absence any contraindications for transfer, including:
- Ongoing need for Renal Replacement Therapy
- Vasopressor use for two days prior
- Active delirium or ongoing sedation
- Infective process requiring a cubicle
- Significant cardiovascular disease
Criteria for transferring a tracheosomised patient to a COVID-19 ward
The consideration to transfer a patient from critical care to a COVID-19 ward which is equipped to care facilitate tracheostomy ventilation weaning should prompt a discussion between the ward team and the critical care team. Patients should meet the locally agreed inclusion criteria, for example:
- Resolution of multi-organ failure
- Tracheostomy in situ
- Awake and alert
- Decision on re-escalation has been made
In addition, they should also have absence any contraindications for transfer, including:
- Ongoing need for Renal Replacement Therapy
- Vasopressor use for two days prior
- Active delirium or ongoing sedation
- Infective process requiring a cubicle
- Significant cardiovascular disease
Resources
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All Wales Pathway for Weaning COVID-19 patients with Tracheostomies
The management of tracheostomised patients with COVID-19, their transfer from ITU to a COVID-19 ward, their weaning from invasive ventilation and eventual decannulation of the tracheostomy should follow a structured approach.
