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Home | Articles | Ear, Nose and Throat | Safe Transfer of Patients with Tracheostomy/Laryngectomy within DGRI

Safe Transfer of Patients with Tracheostomy/Laryngectomy within DGRI

Last updated 5th March 2024

Before Transfer to Ward B3 or Rehab ward D7 from CCU

  1. Transfer does not take place until patient is medically stable. Risk assessment completed.
  2. Decision for transfer is made at consultant level.
  3. All transfers to be agreed by medical teams and in consultation with the nurse in charge of the receiving ward and the capacity manager / nurse in charge of the hospital to agree bed availability, adequate staffing levels, with the skills and knowledge to deliver safe care for the tracheostomy/laryngectomy patient.
  4. Essential equipment is available and set up in the room. The CNS Head and neck will help with this whenever possible.
  5. A patient with a tracheostomy/laryngectomy should be discharged to a general ward at a time convenient to both teams and should be transferred between the hours of 0800 -­ 1700, Monday-Friday.  Out of hours only in exceptional circumstances.
  6. A full comprehensive nursing and medical handover between critical care staff and the parent team should take place prior to the transfer of any patient with a tracheostomy/laryngectomy to a general ward.
  7. The Head and Neck CNS must be informed of the transfer of all tracheostomy/laryngectomy patients.
  8. NB patients with a cuffed tracheostomy tube in situ, even with an inner cannula are at a high risk from respiratory obstruction unless under close supervision. This is the reason why this type of patient is not suitable to be nursed in a general ward but in CCU.

Essential Equipment

  1. Tracheostomy bed signs and algorithms should be with all tracheostomy/laryngectomy patients
  2. Functional suction apparatus-with appropriate sized catheters. (suction guidelines, half the size of the tracheostomy tube x3. Size 8 tracheostomy tube would have size 12fg suction catheters)
  3. Oxygen administration –humidified oxygen ONLY.
  4. Emergency resuscitation tray-on third drawer of resuscitation trolley in ED and CCU only.
  5. Nurse calls system.
  6. Spare tracheostomy tube and one size smaller
  7. Humidification i.e. Airvo 2 humidifier, HME, Buchanan Bib.
  8. Tracheostomy dressings/Tracheostomy holders.
  9. Appropriate cleaning swabs for inner cannula/Cleaning barrier wands
  10. Gloves, Aprons, Visor.
  11. Tracheostomy Passport
  12. Airvo 2 humidifier and tracheostomy trolley with all equipment in B3 treatment room.Tracheostomy equipment blue box in tracheostomy cupboard in oncology department. Airvo 2 spare in tracheostomy cupboard in oncology.

Telephone Numbers for Advice

  • Head and Neck Clinical Nurse Specialists – Linda McCormick 32017 (01387 241017) and Fiona Kerr 33964 (01387 241964)
  • Critical Care – 33476
  • On Call anaesthetist – via switchboard

Content by Linda McCormick