The biggest potential problem for patients with a laryngectomy in a hospital are from confusion or a lack of knowledge about the stoma. The National Reporting and Learning Service (NRLS) continues to capture incidents where a laryngectomee becomes unwell and healthcare staff apply oxygen to their face.
This is the equivelant of putting an oxygen mask on the back of your head. Not only is it ineffective in delivering oxygen, but it risks compounding the error if other staff arrive and then assume that there is a patent upper airway.
If the patient is drowsy, unconscious or agitated, then the mistakes are not always picked up immediately. Talk to the patient and their family and look for a medic-alert bracelet and in the notes. Remember that talking may be a problem. Ensure that the patient is cared for in an appropriate environment and that head and neck staff or outreach teams know that the patient is in hospital.
Fig 1 is a video in which Malcolm discusses first hand the problems that laryngectomees can face in hospital.
Question: Remembering the physiological changes that occur following laryngectomy, can you think of the other potential problems that a laryngectomy patient might face?
The biggest potential problem for patients with a laryngectomy in a hospital are from confusion or a lack of knowledge about the stoma. The National Reporting and Learning Service (NRLS) continues to capture incidents where a laryngectomee becomes unwell and healthcare staff apply oxygen to their face.
This is the equivelant of putting an oxygen mask on the back of your head. Not only is it ineffective in delivering oxygen, but it risks compounding the error if other staff arrive and then assume that there is a patent upper airway.
If the patient is drowsy, unconscious or agitated, then the mistakes are not always picked up immediately. Talk to the patient and their family and look for a medic-alert bracelet and in the notes. Remember that talking may be a problem. Ensure that the patient is cared for in an appropriate environment and that head and neck staff or outreach teams know that the patient is in hospital.
Fig 1 is a video in which Malcolm discusses first hand the problems that laryngectomees can face in hospital.
Question: Remembering the physiological changes that occur following laryngectomy, can you think of the other potential problems that a laryngectomy patient might face?
Answer: Other potential problems include:
The biggest potential problem for patients with a laryngectomy in a hospital are from confusion or a lack of knowledge about the stoma. The National Reporting and Learning Service (NRLS) continues to capture incidents where a laryngectomee becomes unwell and healthcare staff apply oxygen to their face.
This is the equivelant of putting an oxygen mask on the back of your head. Not only is it ineffective in delivering oxygen, but it risks compounding the error if other staff arrive and then assume that there is a patent upper airway.
If the patient is drowsy, unconscious or agitated, then the mistakes are not always picked up immediately. Talk to the patient and their family and look for a medic-alert bracelet and in the notes. Remember that talking may be a problem. Ensure that the patient is cared for in an appropriate environment and that head and neck staff or outreach teams know that the patient is in hospital.
Fig 1 is a video in which Malcolm discusses first hand the problems that laryngectomees can face in hospital.
Question: Remembering the physiological changes that occur following laryngectomy, can you think of the other potential problems that a laryngectomy patient might face?
Answer: Other potential problems include:
The cough isn't as effective following laryngectomy and secretions may be thicker due to reduced humidification. Physiotherapists have a key role.
The biggest potential problem for patients with a laryngectomy in a hospital are from confusion or a lack of knowledge about the stoma. The National Reporting and Learning Service (NRLS) continues to capture incidents where a laryngectomee becomes unwell and healthcare staff apply oxygen to their face.
This is the equivelant of putting an oxygen mask on the back of your head. Not only is it ineffective in delivering oxygen, but it risks compounding the error if other staff arrive and then assume that there is a patent upper airway.
If the patient is drowsy, unconscious or agitated, then the mistakes are not always picked up immediately. Talk to the patient and their family and look for a medic-alert bracelet and in the notes. Remember that talking may be a problem. Ensure that the patient is cared for in an appropriate environment and that head and neck staff or outreach teams know that the patient is in hospital.
Fig 1 is a video in which Malcolm discusses first hand the problems that laryngectomees can face in hospital.
Question: Remembering the physiological changes that occur following laryngectomy, can you think of the other potential problems that a laryngectomy patient might face?
Answer: Other potential problems include:
In the first days following a laryngectomy or fashioning of a tracheo-oesophageal puncture (TEP) for vocalisation, swallowing can be difficult, and may require naso-gastric feeding tubes. Specialist input from ENT and Speech and Language Therapy teams is essential. Most patients will go on to be able to eat and drink normally.
The biggest potential problem for patients with a laryngectomy in a hospital are from confusion or a lack of knowledge about the stoma. The National Reporting and Learning Service (NRLS) continues to capture incidents where a laryngectomee becomes unwell and healthcare staff apply oxygen to their face.
This is the equivelant of putting an oxygen mask on the back of your head. Not only is it ineffective in delivering oxygen, but it risks compounding the error if other staff arrive and then assume that there is a patent upper airway.
If the patient is drowsy, unconscious or agitated, then the mistakes are not always picked up immediately. Talk to the patient and their family and look for a medic-alert bracelet and in the notes. Remember that talking may be a problem. Ensure that the patient is cared for in an appropriate environment and that head and neck staff or outreach teams know that the patient is in hospital.
Fig 1 is a video in which Malcolm discusses first hand the problems that laryngectomees can face in hospital.
Question: Remembering the physiological changes that occur following laryngectomy, can you think of the other potential problems that a laryngectomy patient might face?
Answer: Other potential problems include:
Like any wound, the stoma can break down and cause fistulae between the thin walls of the trachea and oesphagus or pharynx. These are potential problems in the early postoperative phase, requiring specialist input. Bleeding is common too and may be related to wounds, infection or trauma from suction.
The biggest potential problem for patients with a laryngectomy in a hospital are from confusion or a lack of knowledge about the stoma. The National Reporting and Learning Service (NRLS) continues to capture incidents where a laryngectomee becomes unwell and healthcare staff apply oxygen to their face.
This is the equivelant of putting an oxygen mask on the back of your head. Not only is it ineffective in delivering oxygen, but it risks compounding the error if other staff arrive and then assume that there is a patent upper airway.
If the patient is drowsy, unconscious or agitated, then the mistakes are not always picked up immediately. Talk to the patient and their family and look for a medic-alert bracelet and in the notes. Remember that talking may be a problem. Ensure that the patient is cared for in an appropriate environment and that head and neck staff or outreach teams know that the patient is in hospital.
Fig 1 is a video in which Malcolm discusses first hand the problems that laryngectomees can face in hospital.
Question: Remembering the physiological changes that occur following laryngectomy, can you think of the other potential problems that a laryngectomy patient might face?
Answer: Other potential problems include:
Passive (heat and moisture exchange, or HME stoma covers) or active (external) humidification is needed. Thick sputum plugs can occur which may need physical removal.
This might need an endoscope or forceps.
Only instrument the stoma if you know what you are doing.
Humidification is particularly important if the patient is unwell, dehydrated or has a respiratory infection.