Immediate postoperative priorities of care for a patient
with a new tracheostomy include ensuring that the tracheostomy
tube is securely in place and is patent. Routine
care, as well as prompt management of postoperative
complications, can be facilitated by ensuring that proper
equipment and supplies are quickly available. Table 1
lists the contents of a tracheostomy kit that should be
present at the patient’s bedside and, per recommendations,
should accompany the patient whenever he or she
is away from the ICU.2,15,16
The American Academy of Otolaryngology Head and
Neck Surgery recently published consensus statements
for tracheostomy care.2 These statements were developed
by a multidisciplinary panel of experts on care of patients
with a tracheostomy. Using a modified Delphi method,
the panel members completed surveys on various aspects
of care. Consensus was reached on 77 statements that
address the initial change of the tracheostomy tube, management
of emergencies and complications, prerequisites
for decannulation, management of tube cuffs and communication
devices, and specific needs of patients and the
patients’ caregivers. These statements are an important
document because few randomized studies have addressed
these issues, possibly because of the difficulty in study
design and recruitment and because of ethical concerns.
Table 2 provides some of these important statements