Tracheostomy home care: in a resource-limited setting

Vanker, Aneesa; Kling, Sharon; Booysen, J R; Rhode, D; Goussard, Pierre; Heyns, Louis; Gie, R P

doi:10.1136/adc.2010.187153

Cited by 16 publications

(16 citation statements)

References 5 publications

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“…The low percentages in some reference centres [5,6] may be related to the greater use of noninvasive ventilation or the higher number of interventional procedures in chronic obstructive airway disorders [8]. Whereas in earlier decades acquired subglottic stenosis only accounted for a small proportion of tracheostomies (0% [23] to 5% [24]), it was the second most common indication in our series (13.6%), a similar percentage to that found by others [3,8,19], though yet others have reported much higher rates (20-36%) [5,6,16,17,25]. This increase is particularly surprising, as interventional techniques now exist to resolve this condition, often without the need for tracheostomy [5,16].…”

Section: Discussionsupporting

confidence: 69%

“…We did not detect the second peak in the incidence of tracheostomy in adolescents seen by LEWIS et al [15], probably because the age for admission to many children's hospitals in Spain is ,16 yrs, although chronic patients are usually followedup to a later age. As in our series, most studies have found a slightly higher frequency in males (60-63.8%) [6,15,18], though not all (48%) [17].…”

Section: Discussionsupporting

confidence: 52%

“…Over recent years, numerous studies in different countries have reported the individual experience of various hospitals, with the number of patients varying from 36 to 362 over periods of time ranging from 2 to 37 yrs [3,5,6,8,9,[16][17][18]. Review of these reports reveals differences between the various centres.…”

Section: Discussionmentioning

confidence: 99%

“…There has also been a growing trend for the procedure to be used in premature infants (10.8%) [15,20] and in children with multiple chronic disorders or severe congenital diseases in neonatal or paediatric ICUs [9,21,22]. The mean age for tracheostomy in most series ranges from 3.2 to 7.8 months [3,6,8,17], or around 3 yrs of age [2,16]. The higher mean age in our series may be due to its multicentre nature and the inclusion of referral centres for lung transplantation, which greatly increases the upper limit for the procedure.…”

Section: Discussionmentioning

confidence: 99%

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Paediatric patients with a tracheostomy: a multicentre epidemiological study

Pérez-Ruíz¹,

Caro²,

Pérez‐Frías³

et al. 2012

Eur Respir J

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Changes in the indications for tracheostomy in children have led to the progressively greater involvement of the paediatric pulmonologist in the care of these patients. The aim of this study was to review the current profile of tracheostomised children in Spain.We undertook a longitudinal, multicentre study over 2 yrs (2008 and 2009) of all patients aged between 1 day and 18 yrs who had a tracheostomy.The study, involving 18 Spanish hospitals, included 249 patients, of whom 150 (60.2%) were ,1 yr of age. The main indications for the procedure were prolonged ventilation (n5156, 62.6%), acquired subglottic stenosis (n534, 13.6%), congenital or acquired craniofacial anomalies (n525, 10%) and congenital airway anomalies (n524, 9.6%). The most frequent underlying disorders were neurological diseases (n5126, 50.6%) and respiratory diseases (n598, 39.3%). Over the 2-yr study period, 92 (36.9%) children required ventilatory support, and decannulation was achieved in 59 (23.7%). Complications arose in 117 patients (46.9%). Mortality attributed to the underlying condition was 12.5% and that related directly to the tracheostomy was 3.2%.Respiratory complexity of tracheostomised children necessitates prolonged, multidisciplinary follow-up, which can often extend to adulthood.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Paediatric patients with a tracheostomy: a multicentre epidemiological study

Pérez-Ruíz¹,

Caro²,

Pérez‐Frías³

et al. 2012

Eur Respir J

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“…Teaching components: Signs of respiratory distress, infection and skin breakdown, checklist of emergency supplies, contacts, health care provider, pertinent health care personnel and equipment supply company. b. Hands-on components include: when and how to suction the tracheostomy tube, when and how to clean the tube and the surrounding area, when and how to change the tracheostomy tube, use of home equipment [10][11][12].…”

Section: Obligation Of Home Care Education For Tracheostomymentioning

confidence: 99%

Obligation of home care education for tracheostomy

Alam¹,

Rehana²,

Raied

2017

Saf Health

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Background: Patient education facilitates imparting information to the patients and their caregivers by the health professionals and others that alter the patients' health behaviors, improve their health status and upright health safety at home. It strengthens the clinician-patient relationship by demonstrating respect and enhances patients' feelings of self-efficacy resulting in improved health, well-being, safety, and outcomes. It plays a vital role to prevent deadly but easily manageable fatalities that have been occurring at home in patients with various medical devices for permanent disabilities. In this commentary, the obligation of pre-discharge patient education and ensuring standard care at home for the patients with a lifelong tracheostomy is emphasized in particular. Patients with irreversible airway compromise and bulbar paralysis due to various chronic, systemic and autoimmune diseases often have to continue with a lifelong tracheostomy. These patients require a cautious and meticulous home care of the tracheostomy tube and the stoma. A fatal incident that occurred recently and received in the emergency department is mentioned here. It happened due to the failure of a very simple management of tracheostomy complication at home. Conclusion: Many centers and hospitals have their integrated pre-discharge patient education program and checklist. This is particularly mandatory and warrants due attention in regard of sending a patient home with a tracheostomy. A brief span hands-on training and comprehensive educational materials are to be ensured sincerely. It is vital to have/organize the support of relatives or a companion. At least one individual ought to learn how to help the patient in case of emergency. That person should join the patient when he/she gets guidelines in the hospital. Medical information and communication technology and digital modules should also be made easily accessible and user-friendly to the mass people. Then only, this kind of shattering occurrences can be reduced at home settings.

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The ISPAT project: Implementation of a standardized training program for caregivers of children with tracheostomy

Yeğit

Kılınç

Oksay

et al. 2021

Pediatric Pulmonology

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Background: Tracheostomy-related morbidity and mortality mainly occur due to decannulation, misplacement, or obstruction of the tube. A standardized training can improve the skills and confidence of the caregivers in tracheostomy care (TC).Objective: Our primary aim was to evaluate the efficiency of standardized training program on the knowledge and skills (changing-suctioning the tracheostomy tube) of the participants regarding TC.Materials and Methods: Sixty-five caregivers of children with tracheostomy were included. First, participants were evaluated with written test about TC and participated in the practical tests. Then, they were asked to participate in a standardized training session, including theoretical and practical parts. Baseline and

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Tracheostomy home care: in a resource-limited setting

Abstract: Children with tracheostomies can be safely cared for at home, even in a resource-constrained environment, provided training, appropriate technology and social support services are available.

Cited by 16 publications

References 5 publications

Paediatric patients with a tracheostomy: a multicentre epidemiological study

Paediatric patients with a tracheostomy: a multicentre epidemiological study

Obligation of home care education for tracheostomy

The ISPAT project: Implementation of a standardized training program for caregivers of children with tracheostomy

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