Abstract
Background
Emergency physicians must be masters of the airway. The patient with tracheostomy
can present with complications, and because of anatomy, airway and resuscitation measures
can present several unique challenges. Understanding tracheostomy basics, features,
and complications will assist in the emergency medicine management of these patients.
Objective of review
The aim of this review is to provide an overview of the basics and features of the
tracheostomy, along with an approach to managing tracheostomy complications.
Discussion
This review provides background on the reasons for tracheostomy placement, basics
of tracheostomy, and tracheostomy tube features. Emergency physicians will be faced
with complications from these airway devices, including tracheostomy obstruction,
decannulation or tube dislodgement, stenosis, tracheoinnominate fistula, and tracheoesophageal
fistula. Critical patients should be evaluated in the resuscitation bay, and consultation
with ENT should be completed while the patient is in the department. This review provides
several algorithms for management of complications. Understanding these complications
and an approach to airway management during cardiac arrest resuscitation is essential
to optimizing patient care.
Conclusion
Tracheostomy patients can present unique challenges for emergency physicians. Knowledge
of the basics and features of tracheostomy tubes can assist physicians in managing
life-threatening complications including tube obstruction, decannulation, bleeding,
stenosis, and fistula.
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Article Info
Publication History
Published online: March 23, 2016
Accepted:
March 19,
2016
Received in revised form:
March 18,
2016
Received:
December 3,
2015
Footnotes
☆Conflicts of interest: None.
☆☆This clinical review has not been published, it is not under consideration for publication elsewhere, its publication is approved by all authors and tacitly or explicitly by the responsible authorities where the work was carried out, and that, if accepted, it will not be published elsewhere in the same form, in English or in any other language, including electronically without the written consent of the copyright holder.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
