Overview
Like most critical incidents, laryngectomy-related clinical problems are often preceded by warning signs. Because these signs are sometimes only apparent with hindsight, it is essential that you know what to look out for, so that you can troubleshoot at an early stage and stop minor problems escalating.
Laryngectomy-related clinical problems are called 'laryngectomy red flags'.
Why are these red flags so important?
It is easy to develop a false sense of security when a patient has a laryngectomy tube in situ. Remember though that this is an artificial airway, just like an orally inserted tracheal tube.
Problems that arise are therefore airway problems and can develop quickly and dramatically into life-threatening situations, especially if the patient is ventilator-dependent, hypoxic, or critically ill.
Think about a patient in theatre or in an ICU with a large air leak from an tracheal tube - everyone would agree that this needs to be attended to as a matter of urgency. This is the same for a laryngectomy tube.
What should you do if you detect a red flag?
A prompt assessment of the laryngectomy and the patient should be made by someone who is competent to do so. Who this is depends on how the patient is, your role and where you work, but the person making the assessment must to be able to work out what the problem is and address it.
Interventions could range from a simple reassuring assessment, an endoscopic inspection of the tube or airways, or replacement of the laryngectomy tube.