[Loss of airway after tracheotomy or laryngectomy, an algorithm for practice]. / Luchtwegproblemen na tracheotomie of laryngectomie, een algoritme voor de praktijk.

A 71-year-old man underwent facial reconstructive surgery and a tracheotomy after nasal carcinoma. Several hours after surgery, accidental decannulation occurred and the patient died because the airway could not be resecured in time. This incident led to the implementation of an algorithm for emergency airway management in patients with a surgical airway after tracheotomy or laryngectomy. All such patients have an information sheet attached to their bed, together with the appropriate algorithm. This helps staff to provide care in a standardised manner in cases of airway emergency and prevents fixation errors or omission of treatment options.

Health-related quality of life of children with a positive carrier status for inherited cardiovascular diseases.

Familial hypercholesterolemia, hypertrophic cardiomyopathy, and long QT Syndrome are genetic cardiovascular conditions which may lead to sudden cardiac death at a young age. Preventive measures include lifestyle modifications, medications, and/or cardiac devices. Hence, identification of carrier children can protect them for the potentially life threatening consequences at a young age. Yet, informing children about their genetic risk status and subjecting them to treatment may have negative consequences. This preliminary study aimed to explore (1) how the health-related quality of life of carrier children compares to the quality of life of Dutch children in general; and (2) to what extent the carrier children's quality of life and their parents' perception thereof concur. Our method involved carrier children (n = 35), aged between 8 and 18 years, and their parents (n = 37) who completed a self-report questionnaire. Children's health-related quality of life was assessed with a children and parent version of the KIDSCREEN. Dutch reference data were available from a representative national sample. Our results show no statistically significant differences in scores between carrier children and the reference group. Also, no differences were found between carrier children and their parents' ratings, with the exception of the scale "psychological well being". Parents rated their child's psychological well being significantly lower. We identified no problems with the well-being of carrier children as compared to a representative sample of peers. This may offer some initial reassurance to those who have concerns about the implications of genetically testing children for one of these cardiovascular conditions. Yet, attention to possible problems in these children remains warranted.