Annals of Otolaryngology Head and Neck Surgery (ISSN 2835-7132) | Volume 2, Issue 4 | Original Research | Open Access DOI

Use of A New Inexpensive Powered Air-Purifying Device in Facilitating Safe Performance of Tracheostomy in COVID-19 Patients

Chanan Shaul*

Chanan Shaul1*, Yigal Helviz2*, Frederic S. Zimmerman2, Daniel Belman2, Eli Ben-Chetrit3, Philip D. Levin3

1Department of Otolaryngology, Shaare Zedek Medical Center, Israel

2Department of Intensive Care Unit, Zedek Medical Center, Israel

3Department of Infectious Disease Unit, Zedek Medical Center, Israel

*Equally contributed

*Correspondence to: Chanan Shaul 

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Purpose: This retrospective cohort study describes use of novel PPE and technique to facilitate safe performance of tracheostomy in 9 patients requiring mechanical ventilation in a COVID-19 designated ICU.

Materials and methods: Standard personal protective equipment - including double gloves, full body overall with hood, shoe covers, a single-use N95 mask and a face shield -was employed by all team members. In addition, a single use low cost powered air-purifying respirator (PAPR) was developed in order to increase safety, visibility, and comfort. This device was worn in addition to standard PPE, covered the entire head and upper torso and employed a belt-worn pump delivering approximately 150 l/min air via a viral filter to the user.

Tracheostomy was performed by a 3-person otolaryngologist and critical care physician team using video laryngoscopy and a single stage dilation percutaneous tracheostomy kit. Mechanical ventilation was paused from after wire passage until dilation and placement of the tracheostomy tube.

Results: No blood oxygen desaturation or other complications were noted during or after the procedure, with no procedure related mortality. No team members subsequently developed COVID-19.

Conclusions: Using novel PPE tracheostomy can be performed safely for both patient and staff despite active COVID-19 infection.


COVID-19; Tracheostomy; Powered air-purifying respirator; PAPR; Ventilator weaning


Chanan Shaul, Yigal Helviz, Frederic S. Zimmerman, Daniel Belman, Eli Ben-Chetrit, Philip D. Levin.Use of A New Inexpensive Powered Air-Purifying Device in Facilitating Safe Performance of Tracheostomy in COVID-19 Patients. Annal of Otol Head and Neck Surg. 2023;2(4):1-5.