Abstract
BACKGROUND: Tracheotomy is a commonly performed procedure in hospitals and may be performed for various reasons by one of several services. Because of the absence of both a defined institution-wide procedure for assessment and recent literature to describe current tracheostomy management, we conducted this retrospective study. METHODS: We reviewed the medical records of all patients for the fiscal year 1992-93 coded as having tracheostomy status prior to admission or having tracheotomy performed during the admission. We attempted to answer (1) Why were tracheotomies performed? (2) Who performed/managed the tracheotomies? (3) What postoperative care was given? RESULTS: Of the 109 patients, 74% were men 13 to 83 years of age. Patients underwent tracheotomy for facial injuries (21%), prolonged ventilation (21%), closed head injuries (20%), other intracranial processes (16%), other head and neck surgery (6%), spinal cord injuries (5%), epiglottitis (3%), and 8% underwent tracheotomy for reasons other than these. Thirty-seven percent were tracked prior to this admission. Of the 93 admissions, 63% had tracheotomy performed during the current admission by General Surgery (27%), Otolaryngology Head and Neck Surgery (46%), Neuro- surgery (22%), Oral and Maxillofacial Surgery (2%), Burns-Plastic Surgery (3%). Of the patients with tracheostomies 67% had orders and 85% had progress notes pertaining to tracheostomy management. Of the 147 admissions, 100 (68%) had Respiratory Care notes regarding tracheostomy. CONCLUSION: Because a number of services with various training backgrounds participate in the care of patients with tracheostomy and because variation exists, a multidisciplinary tracheostomy team appears desirable in a hospital such as ours. [Respir Care 1996;41(1):37-42]
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