Podcast
Questions and Answers
When should cuffed tracheostomy tubes be used?
When should cuffed tracheostomy tubes be used?
- For facilitating oral feedings
- For positive-pressure ventilation or to prevent aspiration (correct)
- For routine daily care
- For long-term mechanical ventilatory support
What do the guidelines recommend for the use of communication devices for pediatric patients with tracheostomy?
What do the guidelines recommend for the use of communication devices for pediatric patients with tracheostomy?
- Guidance is not provided in the text
- Regular use of communication devices to encourage speech development
- Minimal use of communication devices to avoid complications
- Use of communication devices as appropriate for individual patient needs (correct)
What is the recommended approach for routine cleaning and tracheostomy tube change?
What is the recommended approach for routine cleaning and tracheostomy tube change?
- No specific recommendations provided in the guidelines
- Frequent cleaning and tube change to prevent infections
- Cleaning and tube change as per manufacturer guidelines (correct)
- Cleaning only when visible dirt is present
When should active humidification be used for pediatric patients with tracheostomy?
When should active humidification be used for pediatric patients with tracheostomy?
What is the recommended timing for the first tracheostomy change in pediatric patients?
What is the recommended timing for the first tracheostomy change in pediatric patients?
What do the guidelines recommend regarding the timing of oral feedings for pediatric patients with tracheostomy?
What do the guidelines recommend regarding the timing of oral feedings for pediatric patients with tracheostomy?
What software was used to identify and remove duplicate citations?
What software was used to identify and remove duplicate citations?
How were study eligibility criteria assessed?
How were study eligibility criteria assessed?
What was the basis for developing recommendations?
What was the basis for developing recommendations?
What was the purpose of creating evidence tables for each PICO question?
What was the purpose of creating evidence tables for each PICO question?
What can improper cuff care of cuffed tracheostomy tubes in children result in?
What can improper cuff care of cuffed tracheostomy tubes in children result in?
How many articles remained after the removal of duplicates and screening?
How many articles remained after the removal of duplicates and screening?
What does the manufacturer specify for filling the tracheostomy cuff?
What does the manufacturer specify for filling the tracheostomy cuff?
When is an uncuffed tracheostomy tube typically used?
When is an uncuffed tracheostomy tube typically used?
What effect did the speaking valve have on laryngeal aspiration or penetration?
What effect did the speaking valve have on laryngeal aspiration or penetration?
What is the volume needed for cuff seal dependent on?
What is the volume needed for cuff seal dependent on?
What is associated with decreased wound breakdown?
What is associated with decreased wound breakdown?
What does the evidence say about the specific cuff type to reduce tracheal injuries?
What does the evidence say about the specific cuff type to reduce tracheal injuries?
What is a common complication associated with tracheostomy use in children?
What is a common complication associated with tracheostomy use in children?
What is the recommended frequency for changing tracheostomy tubes in children?
What is the recommended frequency for changing tracheostomy tubes in children?
What is the impact of care coordination on children requiring tracheostomy?
What is the impact of care coordination on children requiring tracheostomy?
What is the role of standardized protocols and bundles of care in improving outcomes for children with tracheostomy?
What is the role of standardized protocols and bundles of care in improving outcomes for children with tracheostomy?
What is the current evidence regarding recommendations for a specific device to humidify the inspired gas for children with tracheostomies?
What is the current evidence regarding recommendations for a specific device to humidify the inspired gas for children with tracheostomies?
What is the primary cause of mortality associated with tracheostomy use in infants and children?
What is the primary cause of mortality associated with tracheostomy use in infants and children?
What was the purpose of the guideline developed by the American Academy of Otolaryngology–Head and Neck Surgery Foundation?
What was the purpose of the guideline developed by the American Academy of Otolaryngology–Head and Neck Surgery Foundation?
How did the panel obtain consensus on the recommendations for tracheostomy care?
How did the panel obtain consensus on the recommendations for tracheostomy care?
What databases were used for the literature search on tracheostomy care and techniques in pediatric patients?
What databases were used for the literature search on tracheostomy care and techniques in pediatric patients?
What did the guideline aim to provide evidence-based recommendations for?
What did the guideline aim to provide evidence-based recommendations for?
How were the committee members selected for developing the guideline?
How were the committee members selected for developing the guideline?
What was the purpose of the complete search strategy available in the online supplement?
What was the purpose of the complete search strategy available in the online supplement?
Study Notes
Clinical Practice Guidelines for Pediatric Tracheostomy Care
- The American Academy of Otolaryngology–Head and Neck Surgery Foundation convened a consensus panel to review and clarify aspects of care for children and adults requiring a tracheostomy.
- The panel used a modified Delphi technique to obtain consensus on 43 recommendations for care, including tracheostomy tube material, humidification, cannula type, care with a speaking valve, postoperative care bundle elements, and training requirements for caregivers.
- The guidelines address gaps in currently available consensus guidelines and link essential care components to clinical and process outcomes.
- The purpose of the guideline is to provide guidance on the selection of tracheostomy tube type, use of communication devices, implementation of daily care bundles, timing of the first tracheostomy change, type of humidification, timing of oral feedings, care coordination, routine cleaning, and reducing hospital readmissions.
- The guideline was developed from a systematic review addressing various questions relevant to the management of pediatric patients requiring a surgical airway.
- The committee responsible for developing the guideline was selected by the American Association for Respiratory Care (AARC) based on their expertise, interest, and commitment to the process details.
- A literature search was conducted using PubMed, CINAHL by EBSCOhost, and Scopus.com databases for studies on tracheostomy care and techniques in pediatric patients.
- The search strategies used controlled vocabulary and keyword variations related to tracheostomy care, pediatrics, and outcomes, with no date restrictions applied to the searches.
- The committee members received no remuneration for their participation in the process, and their expenses for the face-to-face meeting were reimbursed by the AARC.
- There is a disclosure of relationships with various organizations for some of the committee members involved in developing the guideline.
- The guidelines aim to provide evidence-based recommendations for the care and management of pediatric tracheostomy patients, addressing various aspects such as device-associated complications, developmental milestones, ICU and hospital readmissions, and cost of care.
- The complete search strategy executed in each database on January 17, 2018, is available in the online supplement.
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Test your knowledge of the clinical practice guidelines for pediatric tracheostomy care with this quiz. Explore recommendations for tracheostomy tube selection, communication devices, care bundles, humidification, oral feedings, and more.
