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 10am in the 8AB meeting room.
Allison Tyndall
Respiratory CNC
Pager 41342
Sarah Webb
ICU Nurse Practitioner
Ext 32609
Jess Butler
ICU Nurse Practitioner
Ext 32609
Elliot Williams
ICU Nurse Practitioner
Ext 32609
Kelly Harbour
ICU Nurse Practitioner
Ext 32609
Jonathan Gatward
ICU Specialist
Sarah Boggiano
Speech Pathologist
Pager 41442
Leisl Davis
Physiotherapist
On-call Pager 41339
Amanda Sukkar
Physiotherapist
On-call Pager 41339
Melissa Cohen
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…
The Agency for Clinical Innovation Clinical Practice Guideline – Care of the Adult Patient with a Tracheostomy – a comprehensive guide to tracheostomy care from New South Wales
The National Tracheostomy Safety Project
Multidisciplinary Guidelines for the Management of Tracheostomy and Laryngectomy Airway Emergencies – Brendan McGrath’s paper on the development of the bed head signs and emergency algorithms we use
Download PDF versions of the bed head signs and algorithms:
For further information on tracheostomy and laryngectomy equipment, and caring for patients with tracheostomy, click image below
