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Akhtar AB, Khan A, Saleem H, Mannan Z, Azhar MN. Emergency Management of Ventilation Failure Through Blocked Tracheostomy Tube in a Paediatric Patient. Cureus 2022; 14:e26873. [PMID: 35978764 PMCID: PMC9375839 DOI: 10.7759/cureus.26873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 11/05/2022] Open
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Russell SM, Highsmith L, Henriquez O, Belagaje S, Moore C. The efficacy of tracheostomy tube changes by speech-language pathologists: A retrospective review. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2017. [DOI: 10.12968/ijtr.2017.24.11.466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims: The number of tracheostomised patients in the acute care setting are increasing, resulting in an equal need of providers who can safely change tracheostomy tubes without complications. The objective of this retrospective study was to ascertain if trained speech-language pathologists were able to safely and efficiently perform tracheostomy tube changes in the acute care setting with minimal adverse events. Methods: Our retrospective case series spans from June 2010 to March 2015 and was completed at an academic hospital with a level 1 trauma designation. A total of 107 consecutive referrals undergoing a tracheostomy tube change, with a speech-language pathologist, were identified. Success was defined as the placement of the tracheostomy tube into the tracheal lumen with confirmation of placement. Only complications occurring at the time of the tracheostomy tube change were considered and were defined as an airway loss event: oxygen desaturation <85%; uncontrollable bleeding >5mL; and the inability to perform the attempted tracheostomy tube change for any other reason. Results: All of the tracheostomy tubes changes were performed at the bedside at a mean of 13 days post tracheotomy (range 3–28). A total of 106 (99%) of 107 tracheostomy tubes changes were successfully completed without complications; 83 (79%) of the tracheostomy tubes changes performed were the initial tracheostomy tubes change completed post tracheotomy. The remaining 23 (21%) were a combination of either the second or third change. One, (less than 1%), of the procedures was attempted and discontinued before the removal of the tracheostomy tubes, and referred back to the surgical services and was successfully managed with no untoward effects to the patient. Conclusions: This is the first study to audit the outcome of speech-language pathologists' ability to successfully change a tracheostomy tube. The findings suggest that specially trained speech-language pathologists, acting as part of a multi-disciplinary care team, have the potential to safely change tracheostomy tubes in an acute care setting with the availability of immediate physician and respiratory therapy support. Additional clinical benefits of the speech-language pathologist changing tracheostomy tubes may include earlier facilitation of communication, decannulation and initiation of nutrition/hydration.
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Affiliation(s)
- Scott M Russell
- Senior speech-language pathologist, Grady Memorial Health System, Atlanta, Georgia, USA
| | - Lindsey Highsmith
- Senior speech-language pathologist, Grady Memorial Health System, Atlanta, Georgia, USA
| | - Oswaldo Henriquez
- Assistant professor, Department of Otolaryngology-Head and Neck Surgery, Emory University; Associate chief, Department of Otolaryngology, Grady Memorial Health System, Atlanta, Georgia, USA
| | - Samir Belagaje
- Assistant Professor, Emory University Department of Neurology and Rehabilitation Medicine; Director, Stroke Rehabilitation, Marcus Stroke and Neuroscience Center, Grady Memorial Health System, Atlanta, Georgia, USA
| | - Charles Moore
- Professor, Department of Otolaryngology-Head and Neck Surgery, Emory University; Chief of service, Department of Otolaryngology, Grady Memorial Health System, Atlanta, Georgia, USA
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McGrath BA. Feedback on ‘Tracheostomy management’, BJA Education , June 2015. BJA Educ 2015. [DOI: 10.1093/bjaed/mkv031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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