Publication for anaesthesia trainees

1. Neck Breathers
Mohamed mohamed

3. Aim
• Raise awareness of special needs of neck
breathers(laryngectomees).
• How to differentiate between partiel and total
neck breathers.
• Rescue breathings?!!!
• Communications.

4. The laryngectomees
• Cancer head and neck
• Speech and communication problems

5. Communication
• Writing
• Silent articulations
• Sign language
• Three speaking methods

6. • Eosophageal voice.
• Voice procethesis(through tracheo-
eosphageal fistula).
• Electronic larynx.

12. Differentiation
• Total neck breathers:no more connections
• Partiel neck breathers : double connections

14. Rescue breathing
• Unresponsivness
• Call emergency system.
• Raise the shoulders and expose the neck.(difficult
to recognise ).
• Clear the area (filters,HME,mucous blogs......
• No need for removal of stoma housing unless It
block the airway.

15. • Voice prosthesis ......never to be removed
unless its blocking the airway.
• If the prosthesis is dislodged it should be
removed and replaced with a catheter to
prevent aspiration and fistula closure.
• Look ,listen and feel not more than 5sec.
(exhalations through the stoma).

16. • laryngectomy tubes and stoma buttons may
be removed carefully if they are blocking the
airway.
• If a tracheostomy tube is used for
Care should be used in .resuscitation
inserting the tube so that it does not
This require . dislodge the voice prosthesis
.the use of a tube with a smaller diameter

17. • Mouth to stoma rescue ventilation (useless
mouth to mouth in neck breathers).
• Infant or toddler mask can be used for
ventilation.
• If if chest fail to rise remove the inner
tube as its a common site of obstruction.

18. Ventilation of
laryngectomees
• Voice prosthesis ......never to be removed
unless its blocking the airway.
• Total neck breathers.....never mouth
ventilation.
• Partiel neck breathers.....stoma and close the
orifices.

20. • Laryngectomees may have difficulties in
communication during respiratory distress.
• Laryngectomees and other neck breathers
can assist in preventing life threatening
mishaps by carrying an emergency card,
displaying an emergency card in their car,
and/or wearing a bracelet or a neck chain that
identifies them as a neck breather.

21. Emergency identification cards and
jewellery