On the right trach – James Watts NCEPOD review

On the right trach – James Watts NCEPOD review

On the right trach Consultant Editor James Watts reviews the NCEPOD tracheostomy survey

The first record of tracheostomy procedures is allegedly recorded on ancient Egyptian tablets dating from about 3600BC [1]. It is also described in the Hindu text the Rigveda, dating from 2000BC [2]. The prominent Greek physician, surgeon and philosopher Galen described the mechanism of ventilation via a reed placed in an animal’s trachea [3]; while legend has it that Alexander the Great saved the life of one of his soldiers by opening his throat with the tip of a sword.
Despite this, the presentation of a tracheostomised patient to a 21st-century physician or nurse can still induce anxiety and concern, even though there are an undefined number of patients who manage to survive perfectly well in the community with a permanent tracheostomy in situ, looking after it by themselves, or in conjunction with non-professional carers.
In 2014, NCEPOD (National Confidential Enquiry into Patient Outcome and Death) published the results of its nationwide survey into tracheostomy care across the UK [4]. The aim of the exercise was to capture data on every tracheostomy performed during the specified time period, from performance in theatre or critical care, to discharge. Following an initial scoping survey, which aimed to identify which hospitals performed tracheostomy, and which wards within their environment were designated as ‘tracheostomy wards’, the survey collected data on 2546 patients who had tracheostomies performed for whatever indication. The purpose was to determine what…

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