Rhinologic Practice Special Considerations During COVID-19: Visit Planning, Personal Protective Equipment, Testing, and Environmental Controls

Brittany E. Howard, Devyani Lal

Research output: Contribution to journalComment/debatepeer-review

5 Scopus citations

Abstract

As rhinologists return to practice amid SARS-CoV-2, special considerations are warranted given the unique features of their subspecialty. Rhinologist manipulation of nasal tissue, proximity, and frequent aerosol-generating procedures (AGPs) create high risk for infection transmission. There are 4 areas of special consideration to mitigate risk: (1) previsit planning for risk stratification/mitigation, (2) appropriate personal protective equipment, (3) preprocedural testing, and (4) environmental controls. During previsit planning, risk factors of the patient and procedures are considered. High-risk AGPs are identified by duration, proximity, manipulation of high–viral load tissue, and use of powered instrumentation. Appropriate personal protective equipment includes selection of respiratory and eye protection. COVID-19 testing can screen for asymptomatic carriers prior to high-risk procedures; however, alternative testing methods are required in rhinologic patients not eligible for nasopharyngeal testing due to nasal obstruction or skull base defects. Last, AGPs in rhinologic practices require considerations of room air handling and environmental controls.

Original languageEnglish (US)
Pages (from-to)676-681
Number of pages6
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume163
Issue number4
DOIs
StatePublished - Oct 1 2020

Keywords

  • COVID
  • COVID-19
  • PPE
  • SARS-CoV-2
  • aerosol-generating procedure
  • air changes per hour
  • air handling
  • environmental control
  • environmental safety
  • eye protection
  • high-risk aerosol
  • oropharyngeal swab
  • otolaryngology
  • personal protective equipment
  • planning
  • respiratory protection
  • rhinologic
  • rhinology
  • testing
  • visit planning

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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