ABSTRACT
The incidence of COVID-19 infection in infants and children is low and most cases have only few (rhinitis, fever) or no symptoms. However, a high viral load may be present in the upper and lower airways thus imposing specific precautions for ENT surgeons taking care of children. In the next paragraphs, we will discuss some situations upon a background of available guidelines for outpatient and in-patient management.
ABSTRACT
OBJECTIVE: Joint guidelines of the French Pediatric Otolaryngology Society (AFOP) and of the French Society of otorhinolaryngology-head and neck surgery (SFORL) on the management of paediatric otolaryngology patients in the context of the COVID-19 pandemic. METHODS: A nation-wide workgroup drew guidelines based on clinical experience, national and local recommendations and scientific literature. Proposals may have to be updated on a day-to-day basis. RESULTS: In children, incidence of symptomatic COVID-19 (1-5%) is low and of good prognosis. The indications for nasal flexible endoscopy should be drastically limited. If undertaken, full Personal Protective Equipment (PPE) including FFP2 masks are required, as well as use of a sheath. Saline nose wash done by caregivers other than parents at home should require PPE. Unless foreign body tracheobronchial aspiration is clinically obvious, CT-scan should be performed to confirm indication of endoscopy. Surgical indications should be limited to emergencies and to cases that cannot be delayed beyond 2 months (especially endonasal, endopharyngeal laryngo-tracheobronchial procedures). Postponement should ideally be a group decision and recorded as such in the medical file. Surgical techniques should be adapted to limit the risk of viral dissemination in the air, avoiding the use of drills, microdebriders, monopolar cautery or lasers. Continuous suction should be placed near the operating field. In case of confirmed Covid-19 cases, or suspected cases (or in some centres systematically), PPE with FFP2 mask should be worn by all staff members present in the operating room.
Subject(s)
Coronavirus Infections/prevention & control , Otolaryngology/methods , Otolaryngology/standards , Pandemics/prevention & control , Pediatrics/methods , Pediatrics/standards , Pneumonia, Viral/prevention & control , Betacoronavirus/isolation & purification , COVID-19 , Child , Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Coronavirus Infections/virology , France/epidemiology , Humans , Infection Control/methods , Infection Control/standards , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , SARS-CoV-2ABSTRACT
The incidence of COVID -19 infection irrfants anci childrerr iS low arld most cases have only few (rhinitis, fever) or rlo sym t ever, a high viral load may he present in the upper and lower airways thus imposirig specific precautions far ENT surgeoris children, Ir.' the next paragraphs, we will discuss some situations upori a background of available guidelines for outpatierit and in -patient marlagement.