Care of adult patients in acute care facilities with a tracheostomy

Head of the bed signage - tracheostomy

Head of bed signage providing information to have readily available at the bedspace of a patient with a tracheostomy. Facilities may have their own signage and provide specific pathways to be followed should complications arise specific to individual patient needs and the clinical environment.

Source: Adapted from the UK national tracheostomy project

Head of the bed signage - laryngectomy

Head of bed signage providing information to have readily available at the bedspace of a patient with a laryngectomy. Facilities may have their own signage and provide specific pathways to be followed should complications arise specific to individual patient needs and the clinical environment.

Source: Adapted from the UK national tracheostomy project

Bedside equipment for patient with tracheostomy

The list of recommended bedside tracheostomy equipment was developed by the clinicians who contributed to the clinical practice guide. The actual equipment required at the bedside may vary according to local health district and unit guidelines.

Source: ACI

Emergency equipment for patient with tracheostomy

The list of recommended emergency tracheostomy equipment was developed by the clinicians who contributed to the clinical practice guide. Emergency equipment should be securely kept in a self-contained box, bag or pack to ensure all equipment is available for emergency management and checked each shift.

Source: ACI

12 essential elements of tracheostomy care poster

Poster released in 2013 outlining the essentail elements of care for adult patients with a tracheostomy.

Source: ACI

Transport checklist for patient with a tracheostomy

An example of a transport safety checklist that should be completed prior to transport if the unit requires one. Ensure emergency tracheostomy equipment is taken on transport.

Source: ACI

Tracheostomy emergency management plan (flow chart)

Algorithm providing an example of an emergency tracheostomy management plan for a patient with a patent upper airway. It was adapted from the UK National Tracheostomy Safety Project.

Source: Adapted from the UK national tracheostomy project

Laryngectomy emergency management plan (flow chart)

The following algorithm is an example of an emergency laryngectomy management plan for a patient with a patent upper airway. It was adapted from the UK National Tracheostomy safety project.

Source: Adapted from the UK national tracheostomy project

Weaning and decannulation flow chart

Adapted from the Northern Sydney LHD guideline. This pathway provides guidance for weaning to decannulation and required observations during this process.

Source: Northern Sydney LHD

Malnutrition universal screening tool

Used for rapid, simple and general procedures by medical, nursing and other staff to identify adults who may be malnourished, at risk of malnutrition or obese. It provides guidelines for clinicans to manage these patients.

Source: BAPEN (UK)

Nutrition risk screening tool

The nutrition risk screening tool can be accessed on page 420 of the ESPEN Guidelines for Nutrition Screening. The tool assists clinicians to predict the risk of malnutrition and then the need for a nutritional assessment and intervention.

Source: Kondrup JE, Allison SP, Elia M, Vellas B, Plauth M. ESPEN guidelines for nutrition screening 2002. Clinical nutrition. 2003 Aug 1;22(4):415-21.

ESPEN guidelines

The 2019 European Society for Parenteral and Enteral Nutrition Guidelines provide the most recent consensus statements on nutrition in the intensive care patient.

Source: Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clinical Nutrition. 2019 Feb 1;38(1):48-79.

Continuing professional development toolkit

This toolkit can be used as a guide by LHDs to develop tracheostomy competencies for different members of the multidisciplinary team. The descriptor specifies the competency, expected performance criteria and the members of the multidisciplinary team.

Source: ACI

Critical care airway management course

A 2-day, practical, hands-on course covering advanced airway management when the going gets tough. CCAM is not about the routine patient in the anaesthetic room, this course will teach you the skills and mindset for when the airway is difficult, the patient sick, the environment challenging, or all of the above.

Source: Critical Care Airway Management

National tracheostomy safety project e-learning modules

Four self-directed modules developed in collaboration between the NHS e-Learning for Healthcare (eLfH) and the Royal College of Anaesthetists e-Learning in Anaesthesia project (eLA)

Source: National tracheostomy safety project (UK)

Difficult Airway Society

The Difficult Airway Society (DAS) publishes evidence-based, peer reviewed guidelines for the use of difficult airway situations and providing simple airwa skills for clinicians.

Source: Difficult Airway Society

Australian and New Zealand College of Anaesthetists

The Australian and New Zealand College of Anaesthetists (ANZCA) is one of the largest specialist medical colleges in Australia and New Zealand, and the region's foremost authority on anaesthesia, pain medicine and perioperative medicine.

Source: Australian and New Zealand College of Anaesthetists

National Tracheostomy Safety Project

UK website developed to improve the safety and quality of care for patients with tracheostomies and laryngectomies through education.

Source: National Tracheostomy Safety Project