Scoring Method for Describing the Position of a Tracheostomy Tube

Aims & Outcomes

• Develop an appropriate bedside scoring method for describing the position and orientation of a tracheostomy tube tip when viewed endoscopically from a standardised position
• Secondary aims

• Correlate the endoscopic views of the tracheostomy tube with the trans-laryngeal views.
• Is it possible to predict the trans-laryngeal view from the endoscopic view.
• Does the position of a tracheostomy tube tip change when the patient is repositioned following percutaneous tracheostomy (when viewed endoscopically)
• Equipment training: Compare the number of supervised endoscopies required to consistently achieve the required standardised view
• Primary outcome

• Determine the scoring system with the best inter-rater agreement as defined by weighted kappa and intra-class correlation coefficients.
• Secondary outcome

• Assess correlation between the best scoring system (chosen by above) with the translaryngeal view
• Tertiary aim - Assessment of training: Determine the number of attempts required to obtain adequate standardised views. This will be a manikin based assessment to demonstrate competence in performing the endoscopies for the study before any procedures are undertaken on patients.

Inclusion criteria

• Adults >16 years old
• Presence of a percutaneous or surgical tracheostomy
• Patient being cared for in the AICU of UHSM

Exclusion criteria

• Endoscopy not clinically appropriate (in the opinion of the attending physician)
• Refusal by patient or their representative