Clinical consensus statement: Tracheostomy care

Ron B. Mitchell, Heather M. Hussey, Gavin Setzen, Ian N. Jacobs, Brian Nussenbaum, Cindy Dawson, Calvin A. Brown, Cheryl Brandt, Kathleen Deakins, Christopher Hartnick, Albert Merati

Research output: Contribution to journalArticlepeer-review

169 Scopus citations

Abstract

Objective. This clinical consensus statement (CCS) aims to improve care for pediatric and adult patients with a tracheostomy tube. Approaches to tracheostomy care are currently inconsistent among clinicians and between different institutions. The goal is to reduce variations in practice when managing patients with a tracheostomy to minimize complications. Methods. A formal literature search was conducted to identify evidence gaps and refine the scope of this consensus statement. The modified Delphi method was used to refine expert opinion and facilitate a consensus position. Panel members were asked to complete 2 scale-based surveys addressing different aspects of pediatric and adult tracheostomy care. Each survey was followed by a conference call during which results were presented and statements discussed. Results. The panel achieved consensus on 77 statements; another 39 were dropped because of lack of consensus. Consensus was reached on statements that address initial tracheostomy tube change, management of emergencies and complications, prerequisites for decannulation, management of tube cuffs and communication devices, and specific patient and caregiver education needs. Conclusion. The consensus panel agreed on statements that address the continuum of care, from initial tube management to complications in children and adults with a tracheostomy. The panel also highlighted areas where consensus could not be reached and where more research is needed. This consensus statement should be used by physicians, nurses, and other stakeholders caring for patients with a tracheostomy.

Original languageEnglish (US)
Pages (from-to)6-20
Number of pages15
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume148
Issue number1
DOIs
StatePublished - Jan 2013

Keywords

  • Adult airway management
  • Pediatric airway management
  • Tracheostomy
  • Tracheotomy

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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