Caring for patients with a tracheostomy at RNSH

The Royal North Shore Hospital Tracheostomy Team is a consultative service that coordinates tracheostomy and laryngectomy care. Patients with a tracheostomy or laryngectomy require complex care that involves clinician input from a wide range of healthcare specialties. Coordination of tracheostomy and laryngectomy care aims to enhance patient safety by reducing variation in practice, ensuring those who provide care are equipped with the correct resources and support to deliver good quality care to this vulnerable cohort of patients.

The tracheostomy team is comprised of a multidisciplinary group of specialised clinicians that work with the primary care team and allied health to support and manage patients with a tracheostomy or laryngectomy. Tracheostomy Team services include:

  • Planning care and ongoing airway management
  • Assisting with tracheostomy/laryngectomy procedures and interventions
  • Clinical support and supervision
  • Education and simulation
  • Patient safety and quality improvement initiatives
  • Patient, family and carer education

Please contact us if you need any help with a patient with a tracheostomy or laryngectomy.

The Team

The Tracheostomy Team meets each week to discuss all the patients in the hospital with a tracheostomy or laryngectomy. They then go to visit some of these patients to help out with any problems. Meetings take place on Mondays at 11pm in the 8AB meeting room.

Allison Tyndall

Respiratory CNC
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Sarah Webb

ICU Nurse Practitioner
Pager 44781

Jess Butler

ICU Nurse Practitioner
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Elliot Williams

ICU Nurse Practitioner
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Kelly Harbour

ICU Nurse Practitioner
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Jon Gatward

Jonathan Gatward

ICU Specialist

Sarah Boggiano

Speech Pathologist
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Leisl Davis

Physiotherapist
On-call Pager 41339

Amanda Sukkar

Physiotherapist
On-call Pager 41339

Safety First

Our first priority is patient safety. We have therefore implemented a system of bed head signs, algorithms and standardised emergency equipment for all our tracheostomy and laryngectomy patients. The signs display details about the patient’s airway, so that the correct action can be taken in the event of an airway emergency. The algorithms guide clinicians through the steps to take, and the emergency equipment box contains everything you might need to manage an airway problem. This equipment should accompany the patient wherever they go.

The Bedhead Signs

We use these bed head signs for all patients with a tracheostomy at RNSH. First choose between the green and pink signs. The green sign is for patients with a tracheostomy and a potentially patent upper airway, and the pink sign is for patients who have undergone laryngectomy.

Then fill in the details with a whiteboard marker pen to denote the type and size of tracheostomy tube, when the stoma was formed, whether there are sutures in place, the grade of intubation (if known) and any other relevant information. The sign should be placed in clear view at the head of the bed.

The Emergency Algorithms

We use these algorithms to help us deal with tracheostomy emergencies. We select the pink or green algorithm depending on whether the patient has a tracheostomy with potentially patent upper airway (green) or a laryngectomy (pink).

Safety First

We keep a box of emergency equipment by the bed of every patient with a tracheostomy at RNSH, so that everything is easily to hand if the patient develops breathing difficulties.

The Video

Here’s a video (made at RPA in Sydney) showing the Tracheostomy algorithm in action…

For further information on tracheostomy and laryngectomy equipment, and caring for patients with tracheostomy, click image below

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