Author: Dan Bewick / Editor: Nick Tilbury / Reviewer: Maad Jasim / Codes: EC12, RP1, SLO3 / Published: 29/11/2021 / Reviewed: 16/12/2024
A 60-year-old man is brought into the emergency department (ED) with acute shortness of breath. He has a tracheostomy, having previously had a cerebrovascular accident (CVA).
In addition to the previous CVA, he has a past medical history of hypertension and takes ramipril, aspirin and simvastatin.
On examination he is in clear respiratory distress and is using his accessory muscles to aid his ventilation. He is cyanosed, pale and clammy.
His observations are:
- Respiratory rate – 40
- SpO2 – 82% with 15L/min of oxygen to both the patient’s tracheostomy and face
- Heart rate – 112
- Blood pressure – 140/78
- Temperature – 35.7
He is frantically pointing at his tracheostomy. You suspect it is acutely obstructed.
10 responses
Thanks. Very practical . Every emergency physician should be familiar with the protocol of dealing with blocked tracheostomy tube. This is something we don’t across in A&E often but it is a true medical emergency and it could be too late till help arrives.
very good tips
Thank you good update
Great step wise explanation.
Thank you for posting this case- very good revision.
Succinct!
Good revision
Thank you . Also check ALS 2021 Guidelines.
Very practical and useful approach
Good revision
Thank you