The Journal of Laryngology & Otology

Main Articles

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

A Darra1 c1, K Dhanjia1 and J Doshia2

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


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)


c1 Address for correspondence: Dr Adnan Darr, Department of ENT, University Hospitals Birmingham NHS Trust, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK E-mail:


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

Competing interests: None declared