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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)

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.


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.


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.


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.

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:
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2 IH 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

3 P 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

4 RA 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

6 S 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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