Changing indications for paediatric tracheostomy and the role of a multidisciplinary tracheostomy clinic

J Laryngol Otol. 2015 Sep;129(9):882-6. doi: 10.1017/S0022215115001140.

Abstract

Objective: This paper presents our experience of managing children with a tracheostomy in a multidisciplinary team clinic consisting of an ENT consultant, paediatric respiratory consultant, a nurse specialist, and speech and language therapist.

Method: A retrospective case note review was conducted of all children seen in the multidisciplinary team tracheostomy clinic (at a tertiary paediatric hospital) between February 2009 and September 2014.

Results: Ninety-seven patients were examined. The most common indications for tracheostomy were: lower airway and respiratory problems (66 per cent), upper airway obstruction (64 per cent), and neurodevelopmental problems (60.8 per cent).

Conclusion: Children with a tracheostomy are a diverse group of patients. The most common indications for paediatric tracheostomy have changed from infective causes to airway obstruction and anomalies, long-term ventilation requirement, and underlying neuromuscular or respiratory problems. Our unified approach empowers the carers and patient, as a home management plan, long-term plan and goals are generated at the end of each appointment.

Keywords: Clinical Nurse Specialist; Otolaryngology; Pediatrics; Pulmonary Medicine; Speech And Language Disorder Rehabilitation; Tracheostomy.

MeSH terms

  • Adolescent
  • Ambulatory Care Facilities
  • Child
  • Child, Preschool
  • Comorbidity
  • Cooperative Behavior*
  • Female
  • Humans
  • Interdisciplinary Communication*
  • Male
  • Otorhinolaryngologic Diseases / surgery*
  • Tracheostomy / methods*