Being faced with any patient who has a breathing problem can be really daunting, even for experts. The presence of a tracheostomy can make things more complicated, or sometimes easier, if you know what to do.

We developed these emergency guidelines after researching what were the most common causes of tracheostomy and laryngectomy problems. The algorithms are paired with bedhead signs that detail critical information about the patient’s airway(s) and guide responders to check and manage the potential problems that are easiest to fix and most likely to resolve the emergency. The algorithms start off simply and require increasing levels of skill, equipment and support if problems aren’t fixed quickly.

The development of these guidelines, the first multidisciplinary tracheostomy and laryngectomy algorithms, is described in our paper, published in Anaesthesia in 2012.

The emergency approach is explained in our: