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Table of Contents
LETTER TO EDITOR
Year : 2020  |  Volume : 10  |  Issue : 2  |  Page : 34-35

Modified technique for obtaining nasopharyngeal swab in a suspected COVID-19 patient


1 Department of Trauma and Emergency, AIIMS, Patna, Bihar, India
2 Department of Anaesthesiology, AIIMS, Patna, Bihar, India
3 Department of Director, AIIMS, Patna, Bihar, India

Date of Submission21-Oct-2020
Date of Acceptance28-Oct-2020
Date of Web Publication18-Feb-2021

Correspondence Address:
Neeraj Kumar
Room No. 503, 5th Floor, New OT Complex, B Block, Department of Trauma and Emergency, AIIMS, Patna - 801 505, Bihar
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jlv.JLV_16_20

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How to cite this article:
Kumar N, Kumar A, Singh PK, Kumar A. Modified technique for obtaining nasopharyngeal swab in a suspected COVID-19 patient. J Laryngol Voice 2020;10:34-5

How to cite this URL:
Kumar N, Kumar A, Singh PK, Kumar A. Modified technique for obtaining nasopharyngeal swab in a suspected COVID-19 patient. J Laryngol Voice [serial online] 2020 [cited 2021 May 11];10:34-5. Available from: https://www.laryngologyandvoice.org/text.asp?2020/10/2/34/309675



Sir,

The causative pathogen of the coronavirus disease 2019 (COVID-19) is severe acute respiratory syndrome coronavirus 2. As its outbreak continues to evolve, we are still learning more about this new virus every day. We know early detection, diagnosis, treatment, quarantine, and isolation strategies of patients with COVID-19 can significantly prevent and control the transmission of the virus. The spread of infection is effectively controlled by rapid contact tracings and strict surveillance. The gold standard method for diagnosing COVID-19 is real-time fluorescence-based real-time polymerase chain reaction of the upper respiratory tract samples, which includes throat swab, nasal swab, and lower respiratory tract samples like bronchoalveolar lavage.[1] The nucleic acid testing of COVID-19 mainly involves the nasopharyngeal swabs. During this swab testing, it produces symptoms such as mild discomfort, sneezing, and coughing of COVID19 patients, which not only produces droplets and aerosol but also directly cause respiratory tract infections in health-care professionals.[2] This can lead to an increased risk of patient cross-infection and environmental contamination.[3] All health-care professionals before nasopharyngeal sampling must wear personal protective equipment. The state the dangers of front approach for obtaining nasopharyngeal sampling by health-care professionals posing more risks.

Hence, we incorporated some useful point at the time of obtaining the nasopharyngeal swab:

  1. The patient should wear his mask over the mouth such that the upper border of the mask lies at the upper part of the lip. Hence, there is no need to remove this face mask during the procedure as it mainly protects the health-care professionals from exhaled droplets, which may come from the mouth during the procedure
  2. Always stand behind the head end of the patient and with the nondominant hand extend the neck to approximately 70°, then insert flexible wire shaft mini tip swab through the nares parallel to the palate (not upward) until resistance is encountered or the distance is equivalent to that from the ear to the nostril of the patient, indicating contact with the nasopharynx [Figure 1]. Swab should reach depth equal to distance from nostrils to the outer opening of the ear.[4] Gently rub, roll and leave the swab in place for 15–30s and twist three times carefully and slowly remove it. So by incorporating this small changes in obtaining nasopharyngeal sampling by health-care professionals not only avoids the direct close contact with COVID-19 patients but also reduces the anxiety and other negative emotions during the entire procedure.
Figure 1: Patient wearing the mask at the time of nasopharyngeal swab collection and person obtaining the swab standing at the head end of the suspected COVID patient

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
National Administration of Traditional Chinese Medicine. The National Health Commission of the People's Republic of China: Corona Virus Disease 2019 Diagnosis and Treatment plan (54 trial edition revised version); 2020.  Back to cited text no. 1
    
2.
World Health Organization. Infection Prevention and Control during Health Care When Novel Coronavirus (nCoV) Infection Suspected. World Health Organization; 2020. Available from: https://www.who.int/publicationsdetail/infection-prevention-and-control-during-health- care-when-novel-coronavirus-(ncov)-infection- is-suspected-20200125. [Last accessed on 2020 Feb 17].  Back to cited text no. 2
    
3.
Emergency General Hospital; 2020. Manual for Prevention and Control of Novel Coronavirus Pneumonia. Available from: http://www.xinhuanet.com/politics/2020-01/28/c_1125508409.htm. [Last accessed on 2020 Feb 17].  Back to cited text no. 3
    
4.
Centers for Disease Control and Prevention. Interim Guidelines for Collecting, Handling, and Testing Clinical Specimens from Persons for Coronavirus Disease 2019 (COVID-19). Available from: https://www.cdc.gov/coronavirus/2019-ncov/lab/guidelines-clinicalspecimens.html.opens in new tab. [Last accessed on 2020 Apr 14].  Back to cited text no. 4
    


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