Emergency First Aid for the Laryngectomee:

 EQUIPMENT (IF AVAILABLE)

 Suction Equipment’s
 Sterile Gloves
 Sterile Saline
 Sterile Disposable Catheter (#14 to #16 F Adult)
 Portable Mask and Bag

Nursing Action Rationale

Performance Phase:
1. Place the patient on his or her back on a firm
surface, head straight, chin up. Bare the neck down
to the sternum.
2. Position a blanket or any article of clothing under
the shoulders
3.Make a rapid assessment of the situation:
a. Is victim wearing a tracheostomy or laryngectomy
tube?
b. Has patient been operated on recently?
1. Facilitates access to the laryngeal stoma and
observation of thoracic movement.
2. Promotes extension of the neck area,
permitting access.
a. In a laryngectomee, tube removal cannot
cause immediate danger.
b. If so, tracheostomy tube cannot be removed.

c. Check for tracheal obstruction. Clean stomal c. Mucus and other material may account for
opening of mucus and encrusted matter. obstruction. Use clean cloth or handkerchief—
never tissue.

4. Start mouth-to-neck breathing promptly: Position 4. Second’s count. Do not remove the tube
yourself at side of victim. Place your mouth and
lips/mask tightly over neck opening or around the
tracheal tube if the person is wearing on
5. If suction equipment is available, insert a soft 5. A partially open airway transporting air to
rubber tube 3−5 inches (7.5−12.5 cm) into opening the victim is infinitely better than a clean
for a few seconds. airway that does not supply air at this crucial
time.
6. Blow in a sufficient amount of air to see chest 6. Indicates ventilation
rise; then release and allow chest to fall.
7. For the first 5 seconds, repeat every 1−2 second; 7. Allows air to exhale passively
then slow down to a steady pace of every 4−5
second (12−20 times per minute).
7. Allows air to exhale passively
FOLLOW UP PHASE:
1. When spontaneous breathing occurs,
provide oxygen from a portable supply.
2. If breathing fails again, resume mouth-to-
neck breathing.
3. You can also use a manual resuscitation
bag with an infantsize mask.
4. Watch the chest rise
5. Observe the patient constantly
1. Relieves hypoxemia.
3. Attach infant-size mask; be sure there is a
tight seal against neck opening. Because a
tight seal is difficult to maintain and because
pressure of the mask on the major blood
vessels of the neck may interfere with blood
supply to the brain, mouth-to-neck breathing
is safer and better.
4. Easiest way to detect spontaneous
breathing
4. Easiest way to detect spontaneous
breathing