EAC Laryngectomy & Tracheostomy Flashcards
Define:
Laryngectomy
Is the removal of the Larynx and separation of the airway from the mouth, nose and oesophagus
In a total Laryngectomy the entire Larynx is removed
In a partial Laryngectomy only a portion of the larynx is taken out
The Laryngectomee breathes through an opening in the neck known as a stoma
This procedure is usually performed in cases of Laryngeal cancer
Define:
Tracheostomy
A surgical procedure which consists of making an incision on the anterior aspect of the neck and opening a direct airway through an incision in the trachea
Unlike a Laryngectomy, there is no removal of the larynx
The resulting stoma can serve independently as an airway or as a site for a tracheostomy tube to be inserted
This tube allows a person to breathe without the use of he or her nose or mouth
Define:
Total Neck Breather
After a total Laryngectomy the individual is breathing through the stoma where the tracheostomy opens in the neck.
There is no longer a connection between the trachea, the mouth and nose
Define:
Partial Neck Breather
After a partial Laryngectomy the individual breathes mainly through the stoma, but a connection still exists between the trachea and upper airways.
These individuals are able to breathe air through the mouth and nose
capability to breathe through mouth and nose varies and a tracheostomy tube is present in most cases.
ventilation and resuscitation should be through the stoma
State how Laryngectomy patients communicate
Artificial Larynx
The oesophageal voice
Silent mouthing, writing and gestures
when communicating with Laryngectomy patients:
DO
Give plenty of time to speak
Ask them to repeat if you don’t understand
Watch persons lips if you are finding it hard to understand
Ask about their voice prosthesis and if its blocking their airway. most will be able to tell you how to change their valve.
when communicating with Laryngectomy patients:
DONT
Hurry them, pressure will considerably affect their ability to communicate
Pretend to understand if you don’t
Avoid eye contact during conversion
Remove a voice prosthesis if they are unconscious, unless it is obviously fully displaced or blocking the trachea
complications with Laryngectomy patients
Fistula: frequently after radio therapy prior to surgery
Breakdown of wound: after radiotherapy
Dysphagia (diff swallowing): due to oesophageal stricture
Chest infection: bypassing the normal respiratory filters
Stoma shrinkage: pt’s should wear a stoma button or trachy’ tube at night
Recurrence of cancer: a possibility
oxygen therapy for Laryngectomy patients
Use the adult tracheostomy mask
50% venture
Flow rate 10L/min
how to nebulise a Laryngectomy patient
Connect neb to t-piece tube from BVM kit attached to tracheostomy mask. So that neb is upright to function
CPR on Laryngectomy patient
Are they breathing?
Yes: high flow O2 to Laryngectomy stoma
NO: CPR if no pulse/signs of life
most Laryngectomy stomas will NOT have a tube in situ
