Date of Award

Spring 5-8-2020

Document Type

DNP Project

Project Team Faculty Member

Debra Jenkins, PhD, RN

Project Team Faculty Member

Rebecca Collier, DNP, CRNA, APRN

Project Team Faculty Member

Jeff Adkins, DNP, CRNA

Keywords

laryngotracheal stenosis, subglottic stenosis, idiopathic subglottic stenosis, acquired subglottic stenosis, iatrogenic stenosis, post-intubation subglottic stenosis

Abstract

Laryngotracheal stenosis (LTS) is the luminal compromise at the laryngeal, subglottic, or tracheal level (Gelbard et al., 2014). Various etiologies for LTS exist. Endotracheal cuff over-inflation, inappropriately sized endotracheal tubes, and sudden movements of the tube contribute to injury, as well as anatomical differences(Cardillo et al., 2010; Divatia & Bhowmick, 2005; Medina et al., 2009; Miñambres et al., 2009; Nikolovski et al., 2019; Zaghi et al.,2016). The influence of estrogen may contribute to the development of LTS in women during the third through fifth decades Dedo & Catten, 2001; Poetker et al., 2006; Valdez & Shapshay, 2002). The project goal was to provide an evidence-based presentation to potentially reduce the risk of LTS, at a tertiary care center in central Illinois. A pre- and post-survey was taken by 30 respondents, including nine physicians and 21 certified registered nurse anesthetists (CRNAs). The results of the project showed 100% of the respondents felt more knowledgeable about LTS, and 97% felt the information provided would positively impact practice change. Using a cuff manometer to determine accurate ETTc pressure was not an easily accepted practice change. Future projects could aim to identify specific barriers to cuff manometer use at the facility.

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