TY - JOUR T1 - Controversies in Tracheostomy for Patients With COVID-19: The When, Where, and How JF - Respiratory Care DO - 10.4187/respcare.08100 SP - respcare.08100 AU - Stephen S Chiang AU - Michel B Aboutanos AU - Randeep S Jawa AU - Sanjeev K Kaul AU - Abraham P-H Houng AU - Rochelle A Dicker AU - Weidun A Guo Y1 - 2020/09/01 UR - http://rc.rcjournal.com/content/early/2020/09/01/respcare.08100.abstract N2 - COVID-19 has impacted how we deliver care to patients, and much remains unknown regarding optimal management of respiratory failure in this patient population. There are significant controversies regarding tracheostomy in patients with COVID-19 related to timing, location of procedure, and technique. In this narrative review, we explore the recent literature, publicly available guidelines, protocols from different institutions, and clinical reports to provide critical insights on how to deliver the most benefit to our patients while safeguarding the health care force. Consensus can be reached that patients with COVID-19 should be managed in a negative-pressure environment with proper personal protective equipment, and that performing tracheostomy is a complex decision that should be made through multidisciplinary discussions considering patient prognosis, institutional resources, staff experience, and risks to essential health care workers. A broad range of practices exist because there is no conclusive guidance regarding the optimal timing or technique for tracheostomy. ER -