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The Leeds Teaching Hospitals NHS Trust. 10 Year Review of Paediatric Tracheostomies. "Infants and Children who have a Tracheostomy". Changing times. Changing indications for tracheostomy Fewer short-term tracheostomies
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The Leeds Teaching Hospitals NHS Trust 10 Year Review of Paediatric Tracheostomies "Infants and Children who have a Tracheostomy"
Changing times • Changing indications for tracheostomy • Fewer short-term tracheostomies • Most for chronic problems leading to tracheostomy use for months or years
Parental competency in tracheostomy management • 2 carers trained • Gain competencies in: • Suctioning tube • Changing tapes • Changing tubes • Coping with emergencies • Tube obstruction • Tube dislodgement • Basic paediatric life support
Study Objectives • To review indications and length of hospital stay in children undergoing tracheostomy • To highlight reasons for prolonged hospitalisation once medically fit • Identify impediments to timely discharge
Methods • 10 year retrospective study 2000 – 2010 • All children undergoing tracheostomy in LTH • Mr Knight, Mr Crabbe • Identified using theatre database • Case notes reviewed
Data collected • Demographics • Indication for tracheostomy • Length of hospital stay • Reasons for extended stay • Destination on discharge • Mortality
Results • 109 children identified • 101 notes reviewed • Age range 0-15 years • ENT - Mr Knight – 47 • Paed Surgery - Mr Crabbe – 45 • Other - 9
Age distribution No of children
Indications To facilitate artificial ventilation To relieve upper airway obstruction
Indications To facilitate artificial ventilation To relieve upper airway obstruction Bypass blockage or narrowing in upper airway • Weaning from ventilator • Needs prolonged ventilation • Needs regular pulmonary toilet
Time in hospital after tracheostomy Mean 81 days Range 1 – 603 days
Time in hospital after “medically fit” • Mean: 19 days • Range: 0 – 265 days
Time in hospital after “medically fit” Time (days)
Time in hospital after “medically fit” 56 children delayed Time (days)
Time in hospital after “medically fit” 56 children delayed 23% for > 1 month Time (days)
Time in hospital after “medically fit” 56 children delayed 23% for > 1 month Time (days)
Less than 2 weeks • 2 to 4 weeks • 4 to 8 weeks • 8 to 12 weeks • More than 12 weeks