Life‐threatening tension subcutaneous emphysema as a complication of open tracheostomy

Showmaker, Jason A.; Page, Matthew P.

doi:10.1016/j.otohns.2009.09.023

Cited by 7 publications

(6 citation statements)

References 5 publications

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“…Such a circuit can be attached directly to the tracheostomy tube or applied over an open stoma if the tracheostomy tube has been displaced. However, care must be taken as attempting to ventilate through a displaced tracheostomy can cause subcutaneous emphysema and further complicate airway management .…”

Section: Resultsmentioning

confidence: 99%

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Multidisciplinary guidelines for the management of paediatric tracheostomy emergencies

et al. 2018

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Summary Temporary and permanent tracheostomies are required in children to manage actual or anticipated long‐term ventilatory support, to aid secretion management or to manage fixed upper airway obstruction. Tracheostomies may be required from the first few moments of life, with the majority performed in children < 4 years of age. Although similarities with adult tracheostomies are apparent, there are key differences when managing the routine and emergency care of children with tracheostomies. The National Tracheostomy Safety Project identified the need for structured guidelines to aid multidisciplinary clinical decision making during paediatric tracheostomy emergencies. These guidelines describe the development of a bespoke emergency management algorithm and supporting resources. Our aim is to reduce the frequency, nature and severity of paediatric tracheostomy emergencies through preparation and education of staff, parents, carers and patients.

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Section: Resultsmentioning

confidence: 99%

“…We do not recommend attempts at ventilation if a suction catheter will not easily pass as there is a significant risk of causing subcutaneous emphysema if the tube has entered a false passage (Fig. ) .…”

Section: Resultsmentioning

confidence: 99%

Multidisciplinary guidelines for the management of paediatric tracheostomy emergencies

et al. 2018

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“…A management plan that was recently suggested for posttracheotomy subcutaneous emphysema can hardly be implemented in all cases because cases vary significantly. 9,10 The last topic we would like to address is the ongoing discussion on conventional open tracheostomy versus percutaneous tracheostomy. It was recently reported that percutaneous tracheostomy is easier to perform, with less blood loss, and lower incidence of subcutaneous and mediastinal emphysema than conventional surgical tracheostomy.…”

Section: Discussionmentioning

confidence: 99%

“…The authors of this research concluded that conventional open tracheostomy in an operating room is associated with a low complication rate. A management plan that was recently suggested for posttracheotomy subcutaneous emphysema can hardly be implemented in all cases because cases vary significantly 910…”

Section: Discussionmentioning

confidence: 99%

Subcutaneous Emphysema following Emergent Surgical Conventional Tracheostomy

Ardekian

Barák

Rachmiel

2014

Craniomaxillofacial Trauma & Reconstruction

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In maxillofacial surgery, tracheostomy is indicated in congenital, inflammatory, oncologic, or traumatic respiratory obstruction. In traumatic cases, however, it is sometimes hard to implement. We describe subcutaneous emphysema following emergent surgical conventional tracheostomy performed after stab injury to the floor of the mouth. We analyze the course that led to this complication and discuss suggestions on how to avoid it. In addition, we review the literature to improve our knowledge and practice regarding this entity. Massive subcutaneous neck emphysema occurred because ventilation started at the time when the hemorrhage was not completely managed and the tracheal tube was not fully secured. In traumatic cases with profound bleeding, hemorrhage management must be performed carefully. The recommendation not to ventilate until the hemorrhage is completely managed should be observed.

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“…Anaesthesia 2012Anaesthesia , 67, 1025Anaesthesia -1041former is acceptable and the latter is not. There have been several incidents, including deaths, where vigorous attempts at ventilation via a displaced tracheostomy tube have caused significant surgical emphysema, making access to the neck increasingly difficult [7,[83][84][85][86]. This situation is made worse if a fenestrated tube becomes partially displaced [87,88].…”

Section: Assessment Of Tracheostomy Patencymentioning

confidence: 99%

Multidisciplinary guidelines for the management of tracheostomy and laryngectomy airway emergencies

et al. 2012

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SummaryAdult tracheostomy and laryngectomy airway emergencies are uncommon, but do lead to significant morbidity and mortality. The National Tracheostomy Safety Project incorporates key stakeholder groups with multi‐disciplinary expertise in airway management. , the Intensive Care Society, the Royal College of Anaesthetists, ENT UK, the British Association of Oral and Maxillofacial Surgeons, the College of Emergency Medicine, the Resuscitation Council (UK) the Royal College of Nursing, the Royal College of Speech and Language Therapists, the Association of Chartered Physiotherapists in Respiratory Care and the National Patient Safety Agency. Resources and emergency algorithms were developed by consensus, taking into account existing guidelines, evidence and experiences. The stakeholder groups reviewed draft emergency algorithms and feedback was also received from open peer review. The final algorithms describe a universal approach to managing such emergencies and are designed to be followed by first responders. The project aims to improve the management of tracheostomy and laryngectomy critical incidents.

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Life‐threatening tension subcutaneous emphysema as a complication of open tracheostomy

Cited by 7 publications

References 5 publications

Multidisciplinary guidelines for the management of paediatric tracheostomy emergencies

Multidisciplinary guidelines for the management of paediatric tracheostomy emergencies

Subcutaneous Emphysema following Emergent Surgical Conventional Tracheostomy

Multidisciplinary guidelines for the management of tracheostomy and laryngectomy airway emergencies

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