UIHC COVID19 RESPONSE
- General Patient Resources
- If symptomatic call 1-319-384-9010 or utilize the UIHC Video COVID symptom check process
- If you suspect a patient in Iowa has COVID19
- UIHC PPE policies
- The Point
- Iowa Department of Health
GENERAL
- CDC COVID19 for Healthcare Professionals
- Johns Hopkins Coronavirus Resource Center and Tracker
- Help with interpreting abbreviations and terminology [Iowa Protocols Page]
- Bioaerosols, microdroplets, droplets and COVID-19 [Iowa Protocols Page]
OTOLARYNGOLOGY ORGANIZATIONS
- American Academy of Otolaryngology - Head and Neck Surgery COVID19 Resource Site
- Includes recommendations on tracheostomy, adult elective surgeries as well as information on Telemedicine, Critical Care, Financial Assistance Relief and Workplace Guidance
- American Head and Neck Society COVID-19 Bulletin Board
- Compilation of COVID-19 resources with a focus on Head and Neck Oncologists
- Australian Society of Otolaryngology Head and Neck Surgery
- Compilation of COVID-19 resources with Australian specific guidelines
- ENTUK COVID19 Resource Site
- Includes recommendations for laryngoscopy, triaging head and neck cancer patients, tracheostomy and UK specific ENT practice advice.
- ENTtoday
U.S. OTOLARYNGOLOGY PROGRAMS
- Jefferson University Department of Otolaryngology Head and Neck Surgery
- Vanderbilt Bill Wilkerson Center for Otolaryngology and Communication Sciences Department of Otolaryngology-Head and Neck Surgery
- Virtual Grand Rounds "COVID-19 in ENT: Lessons from the Italian Trenches"
MISC. PRACTICE GUIDELINES AND VIDEOS
- American Society of Pediatric Otolaryngology (ASPO) Statement [Posted 23 March 2020]
- American Academy of Otolaryngology - Managing allergy patients during the COVID era - rebooting practices after the pandemic (Video) [Posted 29 April 2020]
- CMS Adult Elective Surgery and Procedure Recommendations [Posted 7 April 2020]
- International Surgical Sleep Society COVID-19 Adult and Pediatric Practice Guidelines
- MEDTRONIC ENT COVID-19 Rountable [Posted 23 April 2020]
- Wind Instrument Aerosol in Covid Era - COVID-19 and horns, trumpets, trombones, euphoniums, tubas, recorders, flutes, oboes, clarinets, saxophones and bassoons [Iowa Protocols Page]
PODCASTS
- American Academy of Otolaryngology
- HeadMirror: Episode on 14 March 2020
- OTOMentor: Now 5 Part series
PPE
- N95 Respirators (HEPA or High-Efficiency-Particulate-Air Filter Respirators) as Personal Protective Equipment (PPE) [Iowa Protocols Page]
- PPE Classification
RESIDENT RESOURCES
- Multi-Institutional Otolaryngology Residency Education – Collaborative Online Video Instruction and Discussion (COVID)
- This collaborative was recently opened to ALL RESIDENTS or others who would like to join using Zoom
- The first lecture has information on the state of program adaptations [23 March 2020]
- Lectures from faculty across the country, available live from 5pm-7pm CST every week day, or recorded and stored for later viewing
Frequently Asked Questions
What are current recommendations for tracheostomy on known COVID + patients?
There are a variety of organizations, many related to Otolaryngology, who have published tracheostomy recommendations (including information on technique and timing for COVID-19 patients). The American Academy of Otolaryngology – Head and Neck Surgery Guidelines were notably last edited on 4/2/2020. They acknowledged that benefits of early tracheostomy in COVID-19 were unclear, though data is accumulating quickly. They recommend not performing a tracheostomy sooner than 2-3 weeks after intubation. Many institutions do not follow this guideline and there is considerable evidence that tracheostomy can shorten mechanical ventilation and ICU stays, decrease episodes of ventilator-associated pneumonia and allow for sedation weaning. All of which help in the setting of limited hospital and ICU beds. Risk to providers is increased and can be mitigated in part with proper PPE and technique. Ultimately timing and patient selection is a conversation between multiple services at each individual institution and guidelines do not apply to all patient situations.
Tracheotomy recommendations during the COVID-19 pandemic
What are the current recommendations for Anosmia associated with COVID-19?
It is widely recognized that anosmia and/or dysgeusia is one of the earliest signatures of COVID-19. These symptoms generally trigger COVID-19 testing per CDC recommendations. As with most aspects of COVID-19 treatment, recommendations change frequently. At present, for diagnosis UPSIT or other smell identification test should be performed. Flexible nasal endoscopy s also helpful in ruling out other causes of olfactory dysfunction. Topical steroids, Vitamin A, Omega 3 and olfactory retraining all may play a role in recovery. More information, including on prognosis, can be found on the Iowa Protocols.
Management of Loss of Sense of Smell (Anosmia) Associated with COVID-19 (SARS-CoV-2 Infection)
What are the implications for musicians?
The implications of COVID-19 aerosol spread are significant for musicians. Significant research is still being conducted but the University of Iowa has done extensive work surrounding guidelines for ventilation, distancing, and protocols for singers and wind instruments.
School of Music COVID-19 Policies
What is our current understanding of PPE?
There are excellent resources both on understanding aerosols and N95 masks on the Protocols. Please refer to the CDC for current most up-to-date public health guidelines on PPE.
Bioaerosols, microdroplets, droplets and COVID-19
What can be done in clinic to mitigate risk of transfer of COVID-19?
While masks should be worn by both patients and providers, the University of Iowa has pioneered multiple techniques that have been shown to additionally decrease aerosol exposure.
Transnasal Laryngoscopy in COVID-19 Era
Transnasal injection to vocal fold in COVID-19 Era
Additionally: KTP Laser Treatment through Flexible Transnasal Laryngoscopy in the COVID Era Setup in Main Operating Room for RRP