Safe reliable atraumatic replacement of misplaced paediatric tracheostomy tubes

Lyons, Marie J.; Cooke, Jo; Cochrane, Lesley; Albert, David

doi:10.1016/j.ijporl.2007.07.017

Cited by 11 publications

(6 citation statements)

References 8 publications

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“…A partially obstructed tube may still need to be replaced. We do not recommend using a bougie or a similar rigid device to assess tube patency as if the tube is partially or completely displaced from the airway, these stiffer devices are more likely to create a false passage . Soft‐tipped suction catheters will not advance significantly into the soft tissues .…”

Section: Resultsmentioning

confidence: 99%

“…For this first tube change we do not recommend using an exchange guide such as a bougie, wire or suction catheter, as the existing tube is likely blocked, or displaced from its intended position. We recommend the use of a dedicated obturator which may ease insertion, reduce trauma and protect the stoma . If the replacement tube appears to be inserted successfully, we recommend a clinical assessment of patency as described above, supported by waveform capnography if available.…”

Section: Resultsmentioning

confidence: 99%

“…If the second attempt at replacement is unsuccessful, we recommend a third attempt using a soft suction catheter to guide placement, much like a Seldinger technique . This attempt should be made using a tube that is one half‐size smaller than the original tube and with attention to positioning as above.…”

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%

Section: Resultsmentioning

confidence: 99%

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Multidisciplinary guidelines for the management of paediatric tracheostomy emergencies

et al. 2018

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“…The suction catheter needs to pass easily beyond the tracheostomy tube tip and into the trachea, and the depth of insertion will depend on the length of the tube in situ [73][74][75]. Gum-elastic bougies or similar introducers should be avoided as these stiffer devices are more likely to create a false passage if the tracheal tube tip is partially displaced [76][77][78] (Fig. 4).…”

Section: Assessment Of Tracheostomy Patencymentioning

confidence: 99%

“…Definitive management of the airway (re-insertion of a tracheostomy or oral tube) is not necessarily required immediately if the patient is not hypoxic. Insertion of an airway device may require expertise and equipment, and harm has resulted from inappropriate attempts to manipulate the stoma blindly when not required [66,76].…”

Section: Removal Of the Tracheostomy Tubementioning

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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Tracheostomy care and management

Cooke¹

2023

The Great Ormond Street Hospital Manual of Children and Young People's Nursing Practices

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Safe reliable atraumatic replacement of misplaced paediatric tracheostomy tubes

Cited by 11 publications

References 8 publications

Multidisciplinary guidelines for the management of paediatric tracheostomy emergencies

Multidisciplinary guidelines for the management of paediatric tracheostomy emergencies

Multidisciplinary guidelines for the management of tracheostomy and laryngectomy airway emergencies

Tracheostomy care and management

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