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. 2025 Oct 18;17(10):e94846.
doi: 10.7759/cureus.94846. eCollection 2025 Oct.

Teaching Foundation Doctors How to Manage Tracheostomy Emergencies

Ashley Wragg  1 , Joe Gleeson-Buddhdev  1 , Thomas Sharp  1 , Reshad Khodabocus  2
Affiliations

Teaching Foundation Doctors How to Manage Tracheostomy Emergencies

Ashley Wragg et al. Cureus. .

Abstract

Background and objective Tracheostomies are increasingly common in both acute and long-term clinical settings. As more and more patients with tracheostomies are being managed on general wards, Foundation Year 1 (FY1) doctors - often the first responders - require competency in managing life-threatening tracheostomy emergencies. This study aimed to investigate whether a short, targeted educational intervention can improve FY1 doctors' knowledge and confidence in this area. Methods A single-centre pilot educational intervention was delivered to 34 FY1 doctors in a UK teaching hospital. The intervention included a 30-minute lecture on surgical airway anatomy and the National Tracheostomy Safety Project (NTSP) algorithm, followed by small-group, high-fidelity simulation scenarios. To evidence improvement in knowledge, a quasi-experimental, single-arm study was undertaken, involving assessment of FY1s' knowledge via a written examination at three time points: pre-educational intervention, immediate post-educational intervention, and one month after the educational intervention. Results Baseline knowledge was poor, with only eight (25%) of 32 FY1 doctors correctly identifying the difference between tracheostomy and laryngectomy, 14 (41%) correctly identifying the breathing route in laryngectomy patients, and only 11 (10%) of the 103 proposed management actions when managing a tracheostomy emergency actions they suggested were specifically correct. Post-intervention, correct responses rose across all domains, with sustained improvements seen one month later for the answers to the second and third questions. Conclusions An educational intervention combining didactic teaching with simulation improved and sustained FY1 doctors' knowledge and preparedness for dealing with tracheostomy emergencies. Despite limitations such as sample size and knowledge-based assessments, these findings suggest that this was a successful pilot intervention. Future efforts should include broader implementation and performance-based assessments.

Keywords: foundation doctors; medical education; near peer teaching; simulation; tracheostomy; tracheostomy complications.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. NHS Health Research Authority issued approval N/A. This work did not require formal ethical review by an NHS Research & Ethics Committee, in line with NHS Health Research Authority guidance. Prior to commencement, the project was reviewed and approved by the Trust’s Director of Medical Education, Dr Reshad Khodabocus, who has provided ongoing oversight throughout. Participation in feedback is entirely voluntary. At the time of collection, participants are informed that their anonymised responses may be used in publications and that they may withdraw their consent at any point. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Stacked bar chart showing participants' self-reported confidence in dealing with tracheostomy emergencies before and after the teaching session
Figure 2
Figure 2. Bar chart showing responses to Q1 before, immediately after, and one month after the educational intervention
Figure 3
Figure 3. Bar chart showing responses to Q2 before, immediately after, and one month after the educational intervention
Figure 4
Figure 4. Bar chart showing responses to Q3 before, immediately after, and one month after the educational intervention
See this image and copyright information in PMC

References

    1. Tracheostomy emergencies in adults. [ Jul; 2025 ]. 2021. https://www.rcemlearning.co.uk/reference/tracheostomy-emergencies-in-adu... https://www.rcemlearning.co.uk/reference/tracheostomy-emergencies-in-adu...
    1. MacGarth B. Vol. 52. Chichester, UK: John Wiley and Sons; 2014. Comprehensive Tracheostomy Care: The National Tracheostomy Safety Project Manual; p. 61.
    1. Improving tracheostomy care in the United Kingdom: results of a guided quality improvement programme in 20 diverse hospitals. McGrath BA, Wallace S, Lynch J, et al. Br J Anaesth. 2020;125:0–29. - PubMed
    1. Tracheostomy emergencies. Bontempo LJ, Manning SL. Emerg Med Clin North Am. 2019;37:109–119. - PubMed
    1. Multidisciplinary guidelines for the management of tracheostomy and laryngectomy airway emergencies. McGrath BA, Bates L, Atkinson D, Moore JA. Anaesthesia. 2012;67:1025–1041. - PubMed

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