This patient safety information leaflet sets out how NHS ambulance trusts and acute trusts with accident and emergency departments can improve the safety of neck breathers.
These are patients who have had a laryngectomy or have a long-term tracheostomy for other reasons. The only way that these patients can breathe or receive oxygen is through their stoma (a hole in the neck).
They may be at risk when receiving emergency care if ambulance and hospital staff are not aware of how to manage their ventilation needs.
A survey of National Association of Laryngectomee Clubs members in October 2003 indicated that patient safety incidents are occurring when emergency care is required. Incidents include administration of oxygen via the nose and mouth, and mucous plugs blocking the airway not being removed from the stoma. The requirements of neck breathers are not consistently included in local resuscitation training programmes.
The National Reporting and Learning Service recommends the following actions:
- Include airway management of patients with stomas in relevant local training courses for all staff working in accident and emergency departments, or other areas where neck breathers are likely to require emergency care.
- Ensure that emergency response vehicles and resuscitation trolleys include appropriate equipment to administer oxygen effectively and manage the airway of a neck breather.
- Make appropriate equipment available for trainers.
