What families have in the emergency tracheostomy kits: Identifying gaps to improve patient safety

Pediatr Pulmonol. 2017 Dec;52(12):1605-1609. doi: 10.1002/ppul.23740. Epub 2017 May 29.

Abstract

Objective: To evaluate the contents of parent-created emergency tracheostomy kits and identify deficiencies.

Methods: This was an observational study. Data on emergency tracheostomy kits were abstracted for 30 consecutive children who had a tracheostomy tube in situ during an outpatient clinic visit with the Division of Respiratory Medicine and/or the Department of Otolaryngology-Head and Neck Surgery at the Hospital for Sick Children between February 1 and October 30, 2016. A checklist of 12 essential items based on expert consensus was used to evaluate each tracheostomy kit.

Results: Emergency tracheostomy kits from all children were missing at least one item from the 12-item checklist. Nineteen (63%) kits had three or more critical items missing. All kits had the same size tracheotomy tube. Twenty-two (73%) kits did not have a half size smaller tracheostomy tube. Fifteen (50%) were missing a manual resuscitation bag and four (13.3%) were missing a suction machine. Children who had tracheostomy tube in situ for ≥4 years were more likely to have ≥3 missing items in their kit (43.4%) compared to those who had tracheostomy tube for <4 years (20%), (χ2 (1) = 9.85, P = 0.0017).

Conclusion: Maintenance of a fully stocked emergency tracheostomy kit can save a child's life. It is incumbent upon healthcare providers to ensure ongoing reassessment of knowledge and skills required to care for a child with a tracheostomy tube and to regularly review the components of a child's emergency tracheostomy kit.

Keywords: pulmonology (general); social dimensions of pulmonary medicine.

MeSH terms

  • Checklist
  • Child
  • Child, Preschool
  • Emergency Treatment / instrumentation*
  • Family
  • Female
  • Humans
  • Male
  • Patient Safety
  • Suction
  • Tracheostomy / instrumentation*
  • Tracheotomy