Laryngectomies, like tracheostomies, are another airway management tool. Laryngectomies tend to be inserted when people have had cancers of the voice box and had the airway itself altered. The trachea, which normally reaches the mouth and nose, is sealed off where the voice box used to be. The only entry for air to go into the patient is now through the laryngectomy. It is stitched to the outside, and there is now a port of exit and entry for air in the neck. If you put oxygen on the mouth and nose, it will not go down into the patient’s airway. The mouth and nose are not connected to the lungs. If in doubt as to whether there is a laryngectomy or a tracheostomy, the procedure is the same for both.
Procedure for People with Laryngectomies
If an oxygen mask is put over the face when the patient has a laryngectomy, the air won’t go anywhere. However, if over a tracheostomy or laryngectomy, it will. Remember, bag valve masks (BVMs) work just the same on a laryngectomy and a tracheostomy as they would on a mouth and nose. A useful tip is to use a paediatric face shield on an adult BVM. This will give you a very nice seal around the laryngectomy or tracheostomy site. This makes it more effective and efficient to put air and oxygen into the patient’s lungs. Remember, the patient’s lungs are much closer to where you are, so you need to be nice and gentle.
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