A Clear Voice

Welcome to our final episode of series one of BLA Connections: A Clear Voice Dr. Paul Bryson chats with Natalie Watson to give his perspective from the U.S. from March 2020 to the 15th of June when we recorded this episode. 

Update: Since the time of recording, the USA has witnessed an increase in Covid-19 infection cases with several states experiencing a surge, Dr. Bryson would like to add "Sadly, the impact on otolaryngology services and health care works and the public in general, personal protective equipment, and the overall public health response in other regions of the United States continues to play out and evolve."

In this episode: 

2:30 Dr. Bryson's brief overview of his experiences in Cleveland, Ohio. 

6:26 Q1.  What's your experience with re-starting surgical services?

10:05 Q2.  What have been some of the challenges to re-starting?

14:44 Q3. What are you planning for the next steps and what are the lasting impacts of COVID-19 to Laryngology?

24:27 Take-home messages for our listeners

Links to relevant documents 

This week Natalie Watson interviewed Michelle Wyatt and Claire Frauenfelder of Great Ormond Street Hospital (GOSH) as they finished a busy shift. In this episode, the recent paper, 'Practical insights for paediatric otolaryngology surgical cases and performing microlaryngobronchoscopy during the COVID-19 pandemic' written by the paediatric ENT team is discussed

*Please note since the time of the recording some of the guidelines for pre-op testing have been modified. 

In this episode: 

1:58 An overview: What's been your experience at GOSH with children suffering from Covid-19

3:17 Q1. Having read your excellent paper there are three clear sections. General pre-operative preparation, performing an MLB and thirdly highlighting modifications for other procedures.  Let’s talk firstly about how your team at GOSH prepares for a procedure.

8:26 Q2. Can you tell us about your experience performing an MLB on a patient with COVID-19?

11:30 Q3. What other modifications or tips would you recommend for other paediatric ENT procedures during the COVID pandemic?

15:57 Q4. What is your experience with PIMS-TS at GOSH? 

17:43 Q5. Have you seen any patterns on dysphonia & dysphagia or anything else you would like to mention from ENT manifestations post Covid-19 either intubated and non-intubated? 

19:30 Q6. What main points would you like our listeners to take home today? 

A Clear Voice is recorded during lockdown and this week Natalie Watson is joined by Ekpemi Irune and Anne Weitzenkorn to discuss Dysphagia and Covid-19 from a multidisciplinary approach. 

In this episode

3:08 Q1.  So how have you approached your management of patients with COVID-19 post-extubation dysphagia?

7:01 Q2.  We are recommencing investigations for dysphagia can you tell us a little bit more about the investigations you are performing to help with the dysphagia diagnosis?

13:00 Q3. What infrastructure are you putting in place to capture these patients and what long term follow up are you planning? 

15:31 Take-home messages: Three main principles - an MDT approach, strategic planning and time.... 

Links to the documents discussed in this episode:

As we continue to bring you A Clear Voice through lockdown Taran Tatla joins Natalie Watson to discuss and explore the impact of Covid-19 and laryngology. In this episode, we look to the future and talk through the BLA and ENTUK guidelines (endorsed by the RCSLT) a graduated return to elective activities for laryngology within the COVID 19 pandemic.

In this episode

8.22 Q1. The document we are discussing is a LIVE document and is subject to change but can you just give us a brief summary of what the main ENT UK guideline entails? 

13:50 Q2. There’s been a lot of discussion about PPE and where’s best to perform outpatient procedures. What are the current recommendations?

19:53 Q3. Now focusing on the laryngology section specifically, (which is available on the BLA website), let’s talk about the main points regarding the surgical priority and activity section. Can you summarise the section?

22:47 Q4. Training has been severely hampered with some being redeployed and operative training grinding down to a halt. There are some really helpful suggestions in the training section and I wondered if you could highlight the key points?

29:34 Take home messages: Communication, Digitial & IT and teamwork, working together for our response...

Links to the documents and audits discussed in this episode:

Yakubu Karagama chats with Natalie Watson on further lessons to learn and insights from treating patients with Covid-19 and the next steps we need to adopt to restart surgical services.

In this episode

3:05 Question 1. From your observations, what practical measures would you suggest to minimise long-term sequelae of laryngotracheal Covid-19?

6:32 Question 2. Are there any guidelines or information sheets you would recommend for our patients post-intubation and post laryngitis?

8:04 Question 3. What follow-up would you recommend for COVID patients who have been intubated or who have had laryngotracheal involvement with their COVID infection?

10:40 Question 4. How do you envisage us moving forward with the recovery of surgical services from Covid-19

16:08 Take-Home Messages ‘Do not rush back without adequate planning…’

Prof Martin Birchall joins Natalie Watson to record the first-ever episode of BLA Connections during lockdown sharing his insights into the laryngological aspects of COVID-19.

In this Episode

2:31 Question 1. COVID 19 seems to be markedly heterogenous in its clinical presentation ranging from people reporting no symptoms to multi-organ failure. From your experience what are the features of the COVID-19 infection in the larynx, pharynx and trachea that you have seen that the ENT community and others should be aware of?

9:20 Question 2. If you can, please share your experience of the micro-laryngoscopy and bronchoscopy of the patient that you have recently discussed.

14:30  Question 3. What are the implications for both the ventilated and non-ventilated patient?

26:06 Take-home message – ‘We need to work together to collect as much information as possible and share as much information as possible’.

Welcome to the British Laryngological Association's podcast series, BLA Connections - A clear voice.  A podcast series for the ENT, medical, and allied professional fields offering support, guidance, and discussion around specific topics, breaking research and updated guidelines. The opinions of our host and guests are their own. Thank you for listening.