Safe emergency care for patients with a tracheostomy
Patients that had a laryngectomy breath trough a ‘hole’ in their throat. When extra oxygen is necessary, the oxygen should be applied in the same way and should have a different percentage of moisture. A lot of caregivers have little to none experience with these patients and have, in emergency situations, applied the oxygen mask in the normal way which resulted into frightening moments for the patients that were slowly suffocating. When in the hospital most nurses don’t know how to take care of the tracheostomy.
How can we convey information, trough the patient, regarding the oxygen administration (where and how) and the care for the tracheostomy to reduce the risks for patients with a tracheostomy?
We had to find a solution that would work and would be on the patient all the time and work for different situations. Finally we concluded that this problem would not be solved by a single solution, but needed multiple solutions for the specific scenarios.
The first solution was focussed on having the information available at any time. The simple web-app that could be handed over by the patient or shared as a link (optional as QR-code) explained what exactly has changed in the throat and how oxygen should be administered like in the image below. We’ve also added tabs for more explanation about taking care for the tracheostomy and a FAQ for some basic information.
We used the image above in the other solutions as well. The patients that have a tracheostomy already had a ’emergency-card’, but it would not stand out in the wallet and didn’t contain any visual information on how to help the patient. We combined the standard information about age, medication and earlier medical interventions with the visual information on how to give oxygen to a person with a tracheostomy. The card was ment to be used when a emergency situation would occur and the patient was unable to speak.
Emergency-Bag – Bring your own kit
Because the group with a tracheostomy consists mostly of people that are 50 years and older they often have other health problems. This results in patients often visiting departments other than the ENT (ear, nose, throat) department. These department usually don’t have the right equipment for taking care of the tracheostomy and administrating oxygen. The emergency bag we designed could fit any standard hospital bed, included a description like the image above and could also contain important tools and parts that are necessary.
EPIC – changing the health record ‘patientheader’
Aside from the solutions that could help these patient in any given situation, we’ve also improved the patient safety at our own hospital. By adding a line of information about the tracheostomy to the ‘patient header’ in EPIC (our system for electronic health records), we can now be sure that patients that were treated in our hospital before received the right care for their specific condition.
What did we do?
REshape facilitated a ’30 day project’ with the department of ERT at Radboudumc and the patient organisation ‘NSvG’ (patient-organisation for people without vocal cords). In the listening fase of this project we spoke to multiple patient with a tracheostomy to learn more from their experience. After we presented our finals concepts the NSvG together with the PWHHT (paramedic workgroup) developed an app based on our ideas.
Een laryngectomie (verwijdering van het strottenhoofd) is een zeldzame procedure. Naar schatting hebben 2000-2500 mensen in Nederland een laryngectomie ondergaan.
Prof. Dr. Nicole BlijlevensInternist Haematologist
“CMyLife improves the quality of care for patients with CML. By allowing people to take control of their own care-process they can better shape their live with the disease in a way that fits their personal situation.”
Barend HeerenProgrammanager HereIsMyData at Radboudumc
“With CMyLife we’re able to empower patients by giving them the tools they need to understand and check if they receive the right care and to manage their own side-effects.”