This information is intended as a guide for staff working in head and neck oncology and due to the nature of the rapidly changing COVID-19 environment is subject to change. All staff should adhere to policy guidelines within their facility and State/Territory guidelines
These guidelines are intended for staff working within outpatient oncology departments including medical (surgical, radiation and medical oncology), allied health (speech pathology) and nursing staff who are working directly with procedures that are deemed at high risk. It is recommended that ENT/Head and Neck Surgeons also ensure compliance to the Australian Society of Otolaryngology Head and Neck Surgery3 (ASOHNS), Australian Society of Anaesthetists4 (ASA) and the NSW Health guideline5 for patients requiring/attending surgery during COVID-19 pandemic.
Risk to healthcare workers through transmission of COVID-19 is primarily through droplet spread and data from China, Iran, Italy and most recently the UK suggest that ENT/Head and Neck Surgeons are a high risk population.
Extrapolating from these data and looking at the identified concern for increased transmission
through aerosol generating procedures, clinicians who are involved in the assessment and management of the upper airway including nasal endoscopy, tracheostomy/laryngectomy management and insertion of nasogastric tubes or manometry catheters are also at an increased risk of COVID-19 exposure. All clinicians should adhere to local and facility policies and State/Territory legislation and guidelines regarding whether the procedure should be conducted and if deemed required, ensure the appropriate use of PPE and the management of suspected or confirmed COVID-19 cases.
Inadequate personal protective equipment (PPE), improper use of PPE, and poor hand hygiene are potential factors that can lead to transmission.
Online PPE training is mandatory for all NSW Health clinical and support staff who work in and around patient areas. Training is available through
My Health Learning.
In all circumstances:
No staff are to undertake or be expected to undertake tasks requiring PPE if the PPE is not available for use.
All staff should adhere to local and facility policies and State/Territory legislation and guidelines. An
information sheet about the use of PPE) during hospital care of people with coronavirus (COVID-19) is has been developed by the Australian Government 6.
Airborne and contact precautions, regardless of COVID-19 status, are recommended for all clinicians performing high risk and aerosol generating procedures (AGPs).
Droplet and contact precautions are recommended.
* Examples of AGPs and other high risk procedures can be found in Guidance on the use of personal protective equipment (PPE) in hospitals during the COVID-19 outbreak.
Dr Nigel Lyons, Deputy Secretary, Health System Strategy and Planning
21 May 2020