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Tracheostomy and laryngectomy survey: do front-line emergency staff appreciate the difference?

  • A Darr (a1), K Dhanji (a1) and J Doshi (a2)
Abstract
AbstractBackground:

In an emergency scenario, it is vital to appreciate the difference between a laryngectomy and a tracheostomy so that oxygen can be administered in an appropriate manner. This survey aimed to ascertain the level of emergency healthcare personnel's knowledge with regards to distinguishing between a tracheostomy and a laryngectomy patient, and the emergency management of such patients.

Methods:

Forty-four accident and emergency staff (28 doctors, nine nurses and seven paramedics) within one Foundation Trust were invited to complete a questionnaire to ascertain (1) their confidence at differentiating between a laryngectomy and tracheostomy stoma; (2) knowledge of the appropriate site for oxygen delivery if needed; and (3) overall level of training on this subject.

Results:

There were significant gaps in knowledge, particularly with regards to fundamental differences between a tracheostomy and a laryngectomy; less than 5 per cent were able to describe the anatomical difference. Only 41 per cent correctly identified the route of oxygen administration in laryngectomy patients.

Conclusion:

In this cohort of emergency staff, the fundamental difference between a laryngectomy and a tracheostomy was poorly understood. This lack of awareness of front-line emergency staff needs to be addressed in order to maximise patient safety.

Copyright
Corresponding author
Address for correspondence: Dr Adnan Darr, Department of ENT, University Hospitals Birmingham NHS Trust, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK E-mail: adnandarr@doctors.org.uk
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2IH El-Sayed , S Ryan , H Schell , R Rappazini , SJ Wang . Identifying and improving knowledge deficits of emergency airway management of tracheotomy and laryngectomy patients: a pilot patient safety initiative. Int J Otolaryngol 2010;638742

3P Casserly , E Lang , J E Fenton , M Walsh . Assessment of healthcare professionals' knowledge of managing emergency complications in patients with a tracheostomy. Br J Anaesth 2007;99:380–3

4RA Clayton , J Henderson , SE McCracken , SJ Wigmore , S Paterson-Brown . Practical experience and confidence in managing emergencies among preregistration house officers. Postgrad Med J 2005;81:396400

6S Heafield , M Rogers , A Karnik . Tracheostomy management in ordinary wards. Hosp Med 1999;60:261–2

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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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