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


CONCLUSIONS
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.
Department of Respiratory Medicine, Solihull Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. adnandarr@doctors.org.uk
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Darr
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Dhanji
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Doshi
D000402:Airway Obstruction / Q000209:etiology / Q000628:therapy*; D002983:Clinical Competence / Q000592:standards*; D003479:Curriculum; D003625:Data Collection; D004638:Emergency Treatment / Q000379:methods* / Q000592:standards; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000592:standards*; D006801:Humans; D007825:Laryngectomy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D020380:Needs Assessment; D010100:Oxygen / Q000008:administration & dosage; D011795:Surveys and Questionnaires; D014139:Tracheostomy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data
D010100:Oxygen