DOI: 10.1093/bjs/znad258.546 ISSN:

1238 Audit of Immediate Management and Self-Reported Confidence When Attending Tracheostomy Emergencies

T Marples, L Nicely, N Kalyal, D Wang, H Hasegawa, R Selway
  • Surgery



To examine staff knowledge and confidence in the initial management of tracheostomy emergencies.


Staff from six predetermined occupation groups within King’s College Hospital London, were identified and asked to complete a survey designed to test their knowledge of the initial management of tracheostomy emergencies and evaluate their self-reported confidence in doing so. As well as collecting role information for data stratification, the survey utilised a 1-10 scale for assessing confidence, fields for listing signs of airway obstruction and initial management of emergencies, and yes/no questions for having prior formal training and for awareness of the NTSP algorithm. Completed surveys were compiled and analysed.


Seventeen members of staff completed surveys (Health care assistants n = 2, Nurses n = 7, nurse associates n = 1, Senior house officers n = 2, Physician associates n = 5, Specialty registrars n = 0). Responses to the immediate management question were accepted as appropriate if they included ‘call for help’, ‘apply oxygen’, ‘ABCDE approach’, or similar. Members from medical professional groups (SHO, PA, SpR) had an appropriate response rate of 71.4% (n = 5), whereas member of the healthcare professional groups (HCA, Nurse, Nurse Assoc.) had an appropriate response rate of 50% (n = 5). Self-reported confidence scored, on average, 3.6/10 for medical professionals and 7.4/10 for healthcare professionals.


According to the design of this survey, appropriate knowledge of the management of tracheostomy emergencies does not necessarily correlate to self-reported confidence. The next steps for this project are to implement MDT teaching at King’s, covering tracheostomy care and emergencies, promoting the algorithm, and encouraging confidence via reassessment.

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