Recommendations From the Italian Society of Otolaryngology for Clinical Management During the SARS-CoV-2 Pandemic
Acta Otorhinolaryngologica Italica
Quaranta, N., Pantaleo, A., et al. (2022).
Acta Otorhinolaryngologica Italica, 42(Suppl 1), S94-S106.
This guideline reports specific recommendations regarding the avoidance of delay in the diagnosis and treatment of head and neck diseases while aldo avoiding healthcare staff exposure to COVID-19. This document is specific to otolaryngology and only the recommendations that apply to speech-language pathology and/or audiology practice are included in this summary
Italian Society of Otolaryngology
<div>This guideline includes the following standard COVID-19 recommendations:</div>
<ul>
<li><span style="color: #333333;">Hand hygiene should be performed prior to touching the patient, before the procedure, after the procedure or body fluid exposure risk, after touching the patient, or after touching the patient's surroundings. </span></li>
<li><span style="color: #333333;">Latex, nitrile, or vinyl gloves are recommended during all procedures, with the use of face shields and goggles to protect mucus membranes of the eyes, nose, and mouth during any procedure that may generate splashes or sprays of bodily fluids. </span></li>
<li><span style="color: #333333;">During any aerosol-generating procedure, a FFP3 mask must be worn. A FFP2 must must be worn for all other medical procedures.</span></li>
<li><span style="color: #333333;">Medical scrubs or uniforms are recommended, and workware should be washed immediately after daily use. </span></li>
<li><span style="color: #333333;">Jewelry use should be avoided. </span></li>
<li><span style="color: #333333;">Disposable instruments are placed in special containers after use post-visit. </span></li>
<li><span style="color: #333333;">Providers or environmental services should provide a thorough cleaning and disinfection of all surfaces and areas in contact with the patient. </span></li>
<li><span style="color: #333333;">High-level disinfection procedures must be performed for equipment such as rigid and flexible endoscopes. </span></li>
<li><span style="color: #333333;">Ventilate all rooms utilized. </span></li>
<li><span style="color: #333333;">Consider covering the computer keyboard with plastic wrap prior to visits for ease of cleaning. </span></li>
<li><span style="color: #333333;">Electronics, including the computer mouse, must be sanitized.</span></li>
</ul>
<div>During audiological testing:</div>
<ul>
<li><span style="color: #333333;">Patients must wear face masks and sanitize their hands before entering the booth and sitting down, without touching items within the room. </span></li>
<li><span style="color: #333333;">Use a recording versus a live voice during vocal tests. </span></li>
<li><span style="color: #333333;">Use protective individual earphone covers. </span></li>
<li><span style="color: #333333;">Allow adequate time between patients for full booth cleaning, disinfecting, and air exchange after each test.</span></li>
</ul>
<div>In case of newborn hearing screening program:</div>
<ul>
<li><span style="color: #333333;">Allow for extra time for testing the newborn must be accompanied by only one parent. The parent must be screened for COVID-19 at triage and use mask and gloves throughout. </span></li>
<li><span style="color: #333333;">The testing PC keyboard and cables must be covered with transparent film or properly disinfected after each performance. </span></li>
<li><span style="color: #333333;">Use inserts if possible, or headphones with disposal coating if not. </span></li>
<li><span style="color: #333333;">Cover the stroller with disposable material. </span></li>
<li><span style="color: #333333;">Re-schedule individuals who have not been screened for COVID-19.</span></li>
</ul>
<div>In the case of patients with tracheostomy:</div>
<ul>
<li><span style="color: #333333;">Always use enhanced PPE if COVID-19 testing has not been performed, with cautious use of standard PPE in cases with confirmed negativity for COVID-19. </span></li>
<li><span style="color: #333333;">For in-person visits, the patient should use a heat moisture exchanger that filters viral or bacterial particles and cover their tracheostomy with a surgical mask. </span></li>
<li><span style="color: #333333;">If not strictly necessary, it may be advisable to postpone the start of the speech therapy in the acute care stage.</span></li>
</ul>
