Laryngectomy and Tracheostomy Emergencies; Roadside to Resus

Tracheostomy and laryngectomy emergencies are classic high-acuity, low-frequency situations. They do not happen every day, but when they do, airway problems can develop quickly, and the wrong intervention can make things significantly worse.

In this episode, we work through the practical approach to these patients, starting with the most important distinction: a patient with a tracheostomy may still have a patent upper airway, whereas someone who has undergone a total laryngectomy is an obligate neck breather. That single anatomical difference determines where oxygen and ventilation need to be delivered.

We'll look at the different tubes, cuffs, inner cannulas, speaking valves and humidification devices you may encounter, before moving through the common causes of deterioration, particularly obstruction, displacement and bleeding.

Using the National Tracheostomy Safety Project's green and red emergency algorithms, we break management down into simple, sequential steps: apply oxygen, remove attachments, remove the inner cannula, pass a suction catheter, deflate the cuff when appropriate and remove a non-functioning tube when necessary.

These cases can initially feel intimidating, but a calm, structured approach can make them far more manageable.

Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom!

Simon. Rob & James

Tämä jakso on lisätty Podme-palveluun avoimen RSS-syötteen kautta eikä se ole Podmen omaa tuotantoa. Siksi jakso saattaa sisältää mainontaa.

Jaksot(286)

August 2026; papers of the month

This month we've got another really varied mix of papers that all have the potential to influence everyday emergency and prehospital practice. We start by asking a question that's becoming increasingl...

2 Elo 35min

July 2026; papers of the month

Welcome back to July's Papers of the Month. This month we've got three papers that tackle some of the biggest questions we face in emergency and critical care medicine. They're all very different stud...

1 Heinä 31min

Excellence in Facemask Ventilation; Roadside to Resus

Face mask ventilation is one of those skills that can easily be overlooked. It's often seen as the simple bit of airway management — something that sits below the glamour of videolaryngoscopy, fibre-o...

16 Kesä 59min

June 2026; papers of the month

This month's episode takes us deep into trauma care, but not just the medicine we deliver but also the systems, circumstances and social factors that shape who survives and who doesn't. We start by lo...

1 Kesä 32min

Reframing Anaphylaxis; Roadside to Resus

Anaphylaxis is one of those conditions we think we have got pretty well sorted. Recognise it early, give adrenaline, support the airway and circulation, and crack on. And in fairness, for the vast maj...

14 Touko 44min

May 2026; papers of the month

This month's Papers of the Month is a real mix of papers that challenge some of the things we think we know, whilst also highlighting just how important systems and processes are in improving patient ...

1 Touko 33min

Excellence in Defibrillation; Roadside to Resus

Timely and effective defibrillation is fundamental to excellent outcomes in cardiac arrest care. But there is a growing body of evidence suggesting that how we deliver those shocks may matter just as ...

8 Huhti 47min