Malfunctioning Tracheostomy

Indications for tracheostomy include prolonged ventilator dependence, history of head and neck radiation treatment, neuromuscular disease, subglottic stenosis, and obstructive disease refractory to treatment. Tracheostomy malfunction can deteriorate rapidly into a difficult airway situation. This chapter reviews how to troubleshoot tracheostomy, discusses medical ethics in acute emergencies, and reviews the advanced cardiac life support (ACLS) algorithm. In addition, this comprehensive chapter provides an overview of the materials needed to develop and implement a successful simulation, including a case scenario, narrative, and progression, as well as a scoring rubric for the evaluation of ACLS and tracheostomy exchange management.