Author: Dan Bewick / Editor: Nick Tilbury / Codes: EC12, RP1, SLO3 / Published: 29/11/2021
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.
Module Content
Tracheostomy Emergencies in Adults
Tracheostomy emergencies are rare in the emergency department but are associated with high mortality and morbidity.
Tracheostomy Emergencies in Adults
Tracheostomy emergencies are rare in the emergency department but are associated with high mortality and morbidity. It is therefore essential that emergency department practitioners are competent in assessing and stabilising patients with complications arising from tracheostomies.
Bowel Obstruction
Intestinal obstruction is an important cause of the acute abdomen, accounting for up to 5% of emergency admissions to surgical services.
8 Comments
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.