title: Changing indications for paediatric tracheostomy and the role of a multidisciplinary tracheostomy clinic.
abstract: OBJECTIVE
  This paper presents our experience of managing children with a tracheostomy in a multidisciplinary team clinic consisting of an ENT consultant, paediatric respiratory consultant, a nurse specialist, and speech and language therapist.
  
  
  METHODS
  A retrospective case note review was conducted of all children seen in the multidisciplinary team tracheostomy clinic (at a tertiary paediatric hospital) between February 2009 and September 2014.
  
  
  RESULTS
  Ninety-seven patients were examined. The most common indications for tracheostomy were: lower airway and respiratory problems (66 per cent), upper airway obstruction (64 per cent), and neurodevelopmental problems (60.8 per cent).
  
  
  CONCLUSIONS
  Children with a tracheostomy are a diverse group of patients. The most common indications for paediatric tracheostomy have changed from infective causes to airway obstruction and anomalies, long-term ventilation requirement, and underlying neuromuscular or respiratory problems. Our unified approach empowers the carers and patient, as a home management plan, long-term plan and goals are generated at the end of each appointment.
authors: Department of Otolaryngology,The Royal Hospital for Sick Children (Yorkhill),Glasgow,UK.
authors: M M C
authors: MM
authors: Yaneza
authors: University of Glasgow Medical School, Glasgow University,Scotland,UK.
authors: H L
authors: HL
authors: James
authors: H P
authors: HP
authors: James
authors: Department of Paediatric Respiratory Medicine,The Royal Hospital for Sick Children (Yorkhill),Glasgow,UK.
authors: P
authors: P
authors: Davies
authors: Department of Otolaryngology,The Royal Hospital for Sick Children (Yorkhill),Glasgow,UK.
authors: S
authors: S
authors: Harrison
authors: Department of Speech and Language Therapy,The Royal Hospital for Sick Children (Yorkhill),Glasgow,UK.
authors: L
authors: L
authors: McAlorum
authors: Department of Otolaryngology,The Royal Hospital for Sick Children (Yorkhill),Glasgow,UK.
authors: W A
authors: WA
authors: Clement
authors: Department of Otolaryngology,The Royal Hospital for Sick Children (Yorkhill),Glasgow,UK.
authors: H
authors: H
authors: Kubba
mesh_terms: D000293:Adolescent; D000554:Ambulatory Care Facilities; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D010038:Otorhinolaryngologic Diseases / Q000601:surgery*; D014139:Tracheostomy / Q000379:methods*
keywords: Clinical Nurse Specialist; Otolaryngology; Pediatrics; Pulmonary Medicine; Speech And Language Disorder Rehabilitation; Tracheostomy