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

A Darr^a1 c1, K Dhanji^a1 and J Doshi^a2

^a1 Department of Respiratory Medicine, Solihull Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

^a2 Department of Otolaryngology, Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UK

Abstract

Background: 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.

(Accepted August 25 2011)

(Online publication April 24 2012)

Key words

• Tracheostomy;
• Laryngectomy;
• Education;
• Airway Management

Correspondence:

^c1 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

Footnotes

Mr A Darr takes responsibility for the integrity of the content of the paper

Competing interests: None declared