COVID-19 Information for the Otorhinolaryngology Community

Elastomeric Respirators: Alternative to Disposable N95 Respirators

During the COVID-19 pandemic, disposable N95 respirators are in short supply; however, such PPE is necessary during all aerosol generating procedures (AGPs). Routine office ENT procedures, including fiberoptic laryngoscopy and nasal endoscopy (with and without debridement), are indeed AGPs. In addition, commmon ENT operating room procedures have also been associated with a risk of inadvertent COVID-19 virus transmission.  Thus, the search for alternatives to the traditional medical-grade N95 respirator has begun with some urgency.

Elastomeric respirators are re-usable respirators originally designed for industrial applications. These devices, if successfully fit-tested for the wearer and used properly, offer protection that exceeds the protection of traditional medical N95 respirator masks. In partnership with UTHealth Environmental Health & Safety, all attending physicians and resident physicians were fit-tested and trained for a half-face elastomeric respirator. Training included a vigorous disinfection protocol to ensure that the elastomeric respirator can be decontaminated between each use.  Each physician has been given an elastomeric respirator for use in the clinic and hospital settings.

It should be noted that while the elastomeric respirator offers excellent protection to its wearer, it does not protect the patient. Thus, a standard surgical mask should be used in conjunction with the elastomeric respirator. The surgical mask also offers some protection of the respirator against visible contamination.

Many different models of elastomeric respirators are available. Government standards are quite specific and each device should carry these regulatory ratings. At UTHealth ORL, these models are in use, although many other models will offer comparable features:

Important Links
Resuable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use
CDC/NIOSH-Approved Elastomeric Respirators with P100 Filters (Brittany E. Howard, MD)
UTHealth Environmental Health & Safety Elastomeric Respirator Disinfection SOP

Otorhinolaryngolology Procedures:  High Risk for Inadvertent COVID-19 Transmission?

Precautions for Endoscopic Transnasal Skull Base Surgery During the COVID-19 Pandemic (Zara M Patel, MD; Juan Fernandez-Miranda, MD; Peter H Hwang, MD; Jayakar V Nayak, MD, PhD; Robert Dodd, MD, PhD; Hamed Sajjadi, MD; Robert K Jackler, MD)

COVID-19 and Ear Surgery (Robert K. Jackler, MD)

Update on Precautions Regarding Endoscopic Procedures & COVID-19 (Zara M. Patel, MD; Peter H. Hwang, MD; Jayakar V. Nayak, MD, PhD; Juan Fernandez-Miranda, MD; Robert Dodd, MD, PhD; Hamed Sajjadi, MD; Robert K. Jackler, MD)

Report from the Stanford Endoscopic Sinus & Skull Base Team (Zara M. Patel, MD; Peter H. Hwang, MD; Jayakar V. Nayak, MD, PhD; Juan Fernandez-Miranda, MD; Robert Dodd, MD, PhD; Hamed Sajjadi, MD; Robert K. Jackler, MD)

Retracing the Path of Contagion Arising From the “Super-Spreader” (Andy Chua, MD)

Smell-Taste Disorders & COVID-19

AAO COVID-19 Anosmia Reporting Tool

AAO-HNS Statement:  Anosmia, Hyposmia, and Dysgeusia Symptoms of Coronavirus Disease (March 22, 2020)

ENT UK Statement:  Loss of Sense of Smell as  Marker of COVID-19 Infection (March 21, 2020)

Otorhinolaryngology Professional Society Position Statements

American Academy of Otolaryngology

Tracheotomy Recommendations During the COVID-19 Pandemic (March 27. 2020)

Academy Supports CMS, Offers Specific Nasal Policy (March 26, 2020)

Position Statement:  Otolaryngologists and the COVID-19 Pandemic (March 23, 2030)

New Recommendations Regarding Urgent and Nonurgent Patient Care  (March 20, 2020)

AAO-HNS Responds to CMS Statement on Adult Elective Surgery and Procedures Recommendations (March 19, 2020)

CMS Adult Elective Surgery and Procedures Recommendations (March 18, 2020)

American Head & Neck Society

How COVID-19 is Affecting our Head and Neck Community:  AHNS COVID-Bulletin (March 23, 2020)

Australian Society of Otolaryngology

Guidance for ENT Surgeons During the COVID-19 Pandemic (March 20, 2020)

American Society of Pediatric Otolaryngology

Message from the President (March 24, 2020)

ENT UK

Tracheostomy guidance during the COVID-19 Pandemic (March 19, 2020)

International Pediatric Otolaryngology Group

IPOG COVID-19 Survey Report (March 31, 2020)

Information for Texas Otorhinolaryngologists

TMB Adopts Emergency Rule Related to Gov. Abbott’s Executive Order GA-19  (May 1, 2020)

Texas Medical Board (TMB) Frequently Asked Questions (FAQs) Regarding Notice and Compliance Requirements Concerning COVID-19 Minimum Standards of Safe Practice (May 1, 2020)

Governor Abbott’s Executive Order Surgical Procedures (April 17, 2020)

TMA Office of the General Council:  TMB Releases Emergency Rules (March 20, 2020)

Texas Medical Board (TMB) Frequently Asked Questions (FAQs) Regarding Non-Urgent, Elective Surgeries and Procedures During Texas Disaster Declaration for COVID-19 Pandemic (March 25, 2020)

TMB Passes Emergency Rules to Enforce Governor Abbott’s Executive Order GA-09 (March 24, 2020)

Governor Abbott’s Executive Order on Elective Surgery (March 22, 2020)

Online Didactic Sessions for Residents

Collaborative Multi-Institutional Otolaryngology Residency Education Program (CMIOREP)

Consortium Of Resident Otolaryngologic kNowledge Attainment (CORONA)

Great Lakes Otolaryngology Consortium (GLOC)