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Identifying and improving knowledge deficits of emergency airway management of tracheotomy and laryngectomy patients: a pilot patient safety initiative.

El-Sayed IH, Ryan S, Schell H, Rappazini R, Wang SJ - Int J Otolaryngol (2010)

Bottom Line: Postintervention, these numbers improved for all groups.Furthermore, 80% of respiratory therapists reported encountering the EAA form in an emergent situation and found it useful.Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, CA 94115, USA.

ABSTRACT
Objectives. To evaluate the knowledge base of hospital staff regarding emergent airway management of tracheotomy and laryngectomy patients, and the impact of the introduction of a bedside airway form. Methods. Cross-sectional surveys of physicians, nurses, and respiratory therapists at a tertiary care hospital prior to and 24 months after introduction of a bedside Emergency Airway Access (EAA) form. Results. Pre- and postintervention surveys revealed several knowledge deficits. Preintervention, 37% of medical internists and 19% overall did not know that laryngectomy patients cannot be orally ventilated, and 67% of internists could not identify the purpose of stay sutures in recently created tracheotomies. Postintervention, these numbers improved for all groups. Furthermore, 80% of respiratory therapists reported encountering the EAA form in an emergent situation and found it useful. Conclusion. A knowledge deficit is identified in caregivers expected to provide emergency management of patients with airway anatomy altered by subspecialty surgeons. Safety initiatives such as the EAA form may improve knowledge among providers.

No MeSH data available.


Laryngectomy patients have no nasal/oral airway (% Correct).
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Related In: Results  -  Collection


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fig4: Laryngectomy patients have no nasal/oral airway (% Correct).

Mentions: Figure 4 demonstrates that preintervention, 37% of medical internists and 19% overall, did not understand that laryngectomy patients no longer have an oral or nasal airway. There was an overall improvement of laryngectomy airway anatomy knowledge in the intervening 24 months. There was also an overall improvement in the understanding that tracheotomy patients can be ventilated orally if the tracheotomy tube is cuffless or deflated (Figure 5). Figure 6 confirms that the majority of caregivers appreciate the danger of blind tube reinsertion in “fresh” tracheotomies. Figure 7 reveals that less than half of caregivers knew to discontinue the futile ventilation of a dislodged or plugged tracheotomy tube and to deflate the tracheotomy cuff for oral ventilation. In addition, nearly half of respondents did not know the purpose of “stay sutures” in a new tracheotomy wound in the event of accidental tube dislodgement (Figure 8).


Identifying and improving knowledge deficits of emergency airway management of tracheotomy and laryngectomy patients: a pilot patient safety initiative.

El-Sayed IH, Ryan S, Schell H, Rappazini R, Wang SJ - Int J Otolaryngol (2010)

Laryngectomy patients have no nasal/oral airway (% Correct).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2877199&req=5

fig4: Laryngectomy patients have no nasal/oral airway (% Correct).
Mentions: Figure 4 demonstrates that preintervention, 37% of medical internists and 19% overall, did not understand that laryngectomy patients no longer have an oral or nasal airway. There was an overall improvement of laryngectomy airway anatomy knowledge in the intervening 24 months. There was also an overall improvement in the understanding that tracheotomy patients can be ventilated orally if the tracheotomy tube is cuffless or deflated (Figure 5). Figure 6 confirms that the majority of caregivers appreciate the danger of blind tube reinsertion in “fresh” tracheotomies. Figure 7 reveals that less than half of caregivers knew to discontinue the futile ventilation of a dislodged or plugged tracheotomy tube and to deflate the tracheotomy cuff for oral ventilation. In addition, nearly half of respondents did not know the purpose of “stay sutures” in a new tracheotomy wound in the event of accidental tube dislodgement (Figure 8).

Bottom Line: Postintervention, these numbers improved for all groups.Furthermore, 80% of respiratory therapists reported encountering the EAA form in an emergent situation and found it useful.Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, CA 94115, USA.

ABSTRACT
Objectives. To evaluate the knowledge base of hospital staff regarding emergent airway management of tracheotomy and laryngectomy patients, and the impact of the introduction of a bedside airway form. Methods. Cross-sectional surveys of physicians, nurses, and respiratory therapists at a tertiary care hospital prior to and 24 months after introduction of a bedside Emergency Airway Access (EAA) form. Results. Pre- and postintervention surveys revealed several knowledge deficits. Preintervention, 37% of medical internists and 19% overall did not know that laryngectomy patients cannot be orally ventilated, and 67% of internists could not identify the purpose of stay sutures in recently created tracheotomies. Postintervention, these numbers improved for all groups. Furthermore, 80% of respiratory therapists reported encountering the EAA form in an emergent situation and found it useful. Conclusion. A knowledge deficit is identified in caregivers expected to provide emergency management of patients with airway anatomy altered by subspecialty surgeons. Safety initiatives such as the EAA form may improve knowledge among providers.

No MeSH data available.