TY - JOUR
T1 - Resuscitating the tracheostomy patient in the ED
AU - Long, Brit
AU - Koyfman, Alex
N1 - Publisher Copyright:
© 2016 Elsevier Inc. All rights reserved.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84962719767&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84962719767&partnerID=8YFLogxK
U2 - 10.1016/j.ajem.2016.03.049
DO - 10.1016/j.ajem.2016.03.049
M3 - Review article
C2 - 27073134
AN - SCOPUS:84962719767
SN - 0735-6757
VL - 34
SP - 1148
EP - 1155
JO - American Journal of Emergency Medicine
JF - American Journal of Emergency Medicine
IS - 6
ER -