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The emergency pager goes off – code blue medical on the gynaecology surgical ward. As you enter the ward a frantic grim faced nurse waves you into the side room where you discover an elderly woman who is obviously cyanosed, not really conscious and struggling vigorously to breath. She has a hudson mask on her face and there is an obvious tracheostomy tube protruding from her neck. One of the nurses tell you she had a laparotomy for ovarian cancer earlier that day and that she has a long term tracheostomy after having had a throat cancer resected 5 years ago…..
Hi Everyone,
This week I am joined by another anaesthetist, Dr James Anderson to discuss the perioperative management of tracheostomies. Before seeing the light and jumping the drapes to become an anaesthetist James spent a year working as an ENT registrar and now he has an interest in teaching both perioperative and crisis management of patients with tracheostomies. He helps run tracheostomy crisis management courses at Fiona Stanley Hospital and helped author a recent article in the famous ANZCA blue book (see the link below):
Unfortunately patients with surgical airways and tracheostomies are not confined to just the ENT wards – they all often have associated comorbidities and medical problems which mean they can be encountered anywhere in the hospital or healthcare settings. Whether we like it or not we could all get called to deal with an emergency – and so we all need to have some basic understanding of tracheostomies and skills in dealing with any crises or problems which could occur! In this episode we discuss the perioperative management and emergency management of these airways.
If anyone is keen to attend the FSH tracheostomy crisis management course, James is happy for you to contact him via email at james.anderson@health.wa.gov.au
Tracheostomy.org.uk emergency management crisis card:
USEFUL LINKS
ANZCA Blue Book 2017 – http://www.anzca.edu.au/documents/australasian-anaesthesia-2017.pdf
https://constitutioncenter.org/blog/the-mysterious-death-of-george-washington