Abstract
Obstruction of a tracheostomy tube is a common cause of respiratory compromise in adults and pediatric patients, which can lead to a life-threatening emergency if it is not properly managed. Compromised airway patency has many potential etiologies; however, the scenario described in this technical report focuses specifically on the management of tracheostomy obstruction through the presence of a mucus plug, blood clot, or highly viscous secretions. The simulation described in this technical report was written to be conducted as an in-situ simulation within the intensive care unit (ICU) at Mzuzu Central Hospital, Malawi. The novel aspect of this report is that it depicts the integration of low-tech simulation with a deteriorating patient scenario educational methodology. This integration enables the use of affordable and sustainable simulation materials in Malawi context to deliver learning objectives that are otherwise not achievable. It was designed to train nurses, clinical officers, and nursing students from the ICU and male/female surgical wards. It can be utilized to train similar learners in other resource-poor regions of the world, as well as remote areas of the more developed countries.
Highlights
Obstruction of a tracheostomy tube is a common cause of respiratory compromise in adults and pediatric patients, which can lead to a life-threatening emergency if it is not properly managed
Compromised airway patency has many potential etiologies; the scenario described in this technical report focuses on the management of tracheostomy obstruction through the presence of a mucus plug, blood clot, or highly viscous secretions
The simulation described in this technical report was written to be conducted as an in-situ simulation within the intensive care unit (ICU) at Mzuzu Central Hospital, Malawi
Summary
Obstruction of a tracheostomy tube is a common cause of respiratory compromise in adults and pediatric patients, which can lead to a life-threatening emergency if it is not properly managed. In a limited resource setting such as Mzuzu Central Hospital, Malawi, where this scenario was developed, the potential for airway compromise via tracheostomy obstruction is increased for a number of reasons. Suction devices are sporadically available and the suction catheters are non-sterile because they are washed and reused between patients due to lack of new equipment; these issues that are present in Malawi (and likely much of the developing world) have the potential to increase infection rates and lead to greater incidence of obstruction. A total of 100 patient beds makes up the intensive care unit (ICU) and male/female surgical wards. The ICU is comprised of four beds and the remaining 96 beds are shared between the male and female surgical wards
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