Everyday I’m Suctioning, Tracheostomy Emergency

Authors: Rajas Virginkar, Sophie Jefferys, Paramjeet Deol / Editors: Fiona Mendes, C. Lockie / Reviewer: Rajas Virginkar / Codes: / Published: 05/01/2024

Mr Harris, a 68-year-old man, is brought in by the ambulance in severe respiratory distress with a gurgling sound heard with each breath. Mr Harris is well known to the Emergency Department (ED) because of a prior haemorrhagic stroke and multiple complications including a permanent tracheostomy.

He appears very agitated using his accessory muscles to breathe. His respiratory rate is 60, and his oxygen saturation is 80% on room air. He does not have a community DNAR (‘do not attempt resuscitation’) form and previous discussions with the family suggest that he is for full aggressive medical management.

Upon assessing him you immediately call for expert help and get the difficult airway trolley ready. You apply oxygen over the mouth and the tracheostomy stoma and attach waveform capnography.

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