• Focussing on the tracheostomy. It is easy to become focussed upon the tracheostomy as the cause of deterioration in a patient. If tube patency has been ascertained using a structured approach, be sure to complete a thorough ACBDE assessment to exclude other conditions causing respiratory distress e.g. pneumothorax.
  • Attempting to ventilate through a displaced tracheostomy tube. This may cause more harm than good and can make further attempts at airway access and management more difficult.
  • Ignoring minor tracheostomy bleeding. Treat any bleeding from a tracheostomy site with an extremely high degree of suspicion and obtain expert review.
  • Being unfamiliar with tracheostomies and associated equipment. Regularly simulate tracheostomy emergency algorithms and familiarise self with patient-specific tubes and adjuncts if time is available on presentation.
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