The following describes oxygen administration to laryngectomy patients with a permanent neck stoma. In these patients, the neck stoma is the only airway.
The method for oxygen administration to tracheotomy patients is somewhat similar, but their neck stoma is generally non-permanent.
Tracheotomy patients have a cannula. The inner cannula may be removed, but not the outer cannula.
Laryngectomy patients have had their larynx removed.
Laryngectomy patients breathe solely through an opening in their neck, the stoma. It is useless to administer oxygen through their nose and / or mouth.
Laryngectomy patients frequently wear a plaster, tube or button with a protective filter.
Various filter types are available, which are also termed HME or artificial nose.
For oxygen administration:
Remove the filter. The plaster, tube, or button can be left in place.
Special devices can be used on the plaster, tube, or button for oxygen administration. The oxygen tube may be attached to the protruding component.
Ask whether the laryngectomy patient has these specific devices on him or her. Possibly these devices are also available through the ENT department of the hospital or can be obtained through the patientassociation.
If these devices are not available, a standard nasal cannula can also be used in combination with a filter
.If these materials are unavailable or the laryngectomy patient does not wear a plaster, tube or button, then use an oxygen mask (children's size) and place it over the tracheostoma.
The primary risk of oxygen administration through a tracheostoma is that mucus dries in the windpipe, causing a hard plug to form, which can become lodged and cause airway constriction and shortness of breath.
Inspect the airway with a lamp or fibrescope as needed. It is strongly recommended to avoid oxygen administration for longer than 1 hour without adequate air moistening.
The following measures should be taken to prevent mucus drying.
1. Administer oxygen using special devices (see above)
2. Administer moistened oxygen. When a filter is used, do not moisten the oxygen as this will make the filter too wet, hindering respiration.
3. Regularly drip saline solution.
Fill a 2 cc syringe with saline solution
- If there is a filter, remove it
- Use the syringe to drip saline solution to induce a cough reflex.
- Catch the mucus using a piece of gauze or remove it by suction
- Repeat as needed.
- If a filter was used, place it back
Should you have any questions as a result of this information, please contact the patient association (030-2321483 email@example.com or the ENT department of a head and neck oncology centre.
Contact information can be found on the website www.nwhht.nl