Comprehensive Tracheostomy Care is a resource developed by the UK National Tracheostomy Safety Project (NTSP) to help promote and facilitate the safe management of tracheostomies and laryngectomies. The scope includes hospital in-patient specialist areas such as critical care, head & neck units and specialist wards, but it is also applicable to more general wards, outpatient and community settings. The majority of the content is for adult patients, complemented by a dedicated paediatric chapter developed with colleagues from Great Ormond Street Hospital.
The manual is a ‘one stop shop’ covering all aspects of tracheostomy and laryngectomy management. It includes multidisciplinary resources from surgical, anaesthetic, nursing, intensive care and allied health backgrounds, along with guidance from key UK stakeholder organisations. Emergency guidance has been reviewed and endorsed by relevant Royal Colleges, national organisations and patient groups.
It takes into account many national and international guidelines, policies and resources. It has been developed by consulting as widely as possible, across traditional professional boundaries using expertise and existing guidance from around the world, including the Global Tracheostomy Collaborative (www.globaltrach.org). Relevant existing resources are brought together coherently, with new resources presented in easy-to-follow text, illustrations, photographs and innovative linked e-learning and interactive resources.
Author(s): Brendan McGrath
Series: Advanced Life Support Group
Edition: 1
Publisher: BMJ Books, Wiley
Year: 2014
Language: English
Commentary: CONVERTED PDF
Tags: Tracheostomy Care; Laryngectomy; Emergency Medicine & Trauma; Emergency Medical Services; Surgery
Cover
Personal Acknowledgements
Title Page
Copyright
NTSP Editorial board
Preface
Acknowledgements
Competing interests
Disclaimer
Contact details and further information
Updates
Executive summary key recommendations
Key issue
Action
Chapter 1: How the NTSP resources were developed
Chapter 2: What is a tracheostomy? What is a laryngectomy?
What is a tracheostomy?
What is a laryngectomy?
Chapter 3: Why and how a tracheostomy is performed
Indications for a tracheostomy
Anatomy relevant to tracheostomy
Types of tracheostomy
Techniques for inserting a tracheostomy
Performing a tracheostomy
Chapter 4: Different types of tracheostomy tubes
Cuffed tubes
Uncuffed tubes
Fenestrated tubes
Single-cannula tubes
Double-cannula tubes
Tubes with sub-glottic suction
Adjustable flange tracheostomy tubes
Choice of tracheostomy tube
Factors influencing temporary tracheostomy tube choice
Tubes from different manufacturers
Chapter 5: Management of the day-to-day needs of the patient with a tracheostomy and laryngectomy
Daily checks
Humidification
Suctioning
Stoma care and securing the tube
Management of the inner cannulae
Oral care and swallowing
Cuff management
Changing tracheostomy tubes
Equipment required for a tracheostomy tube change
Weaning, downsizing and planning for decannulation
Decannulation
Bedside equipment
Humidification and speech after laryngectomy
Patient information sheets examples
Chapter 6: Complications
Complications associated with a tracheostomy
Chapter 7: Red flags
What should you do if you detect a red flag?
Chapter 8: Emergency management of the patient with a tracheostomy or laryngectomy
Guideline development
Patent upper airway: the ‘Green algorithm’
Laryngectomy: the ‘Red algorithm’
Comparison with previously published guidelines
Chapter 9: Paediatric tracheostomy care (with Great Ormond Street Hospital, London)
Background
Indications for tracheostomy in a child
Differences between adult and paediatric airways
Nursing and general care of the paediatric tracheostomy patient
Staff and carer competency guides
Emergency management of the child with a tracheostomy
Discharge from hospital with a paediatric tracheostomy
Chapter 10: Infrastructure considerations
Introduction
Hospital inpatient management
Draft tracheostomy policy outline
Chapter 11: Competencies for staff caring for patients with tracheostomies or laryngectomies
Tracheostomy care: competency assessment criteria
Chapter 12: Courses
Chapter 13: Human factors
Introduction
Human error
Error chains
Communication
Situation awareness
Fatigue
Decision making
Leadership: people, behaviours
Summary
Acknowledgement
Bibliography
Index
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