Laryngectomy and Tracheostomy Emergencies; Roadside to Resus

Tracheostomy and laryngectomy emergencies require a structured, systematic approach to prevent avoidable patient harm. Tracheostomies often maintain a patent upper airway, whereas laryngectomies involve a permanent separation of the upper airway from the lungs, making the stoma the sole route for oxygenation. Clinical management follows the National Tracheostomy Safety Project (NTSP) algorithms, prioritizing the removal of obstructing adjuncts and inner cannulas before testing patency with a soft suction catheter. If obstruction persists, deflating the cuff or removing the tube becomes necessary. In cases of major hemorrhage, maintaining the cuff's position to tamponade the site, combined with direct digital compression and urgent surgical intervention, is critical. These procedures demand clear communication and adherence to established protocols to ensure effective airway management in high-stress, time-sensitive clinical environments.