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Factors Influencing Time-to-OR for Urgent Tracheotomy: A Scoping Review
Raisa Chowdhury1, Jacob G J Wihlidal2, Yvonne Chan2,3
1Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
Ear, Nose, & Throat Journal
|November 7, 2025
Summary
Urgent tracheotomy delays in airway emergencies are often due to institutional barriers like operating room access and staffing. Strategies such as standardized protocols and rapid-response teams can improve patient outcomes.
Area of Science:
- Otolaryngology
- Surgical Critical Care
- Health Systems Research
Background:
- Urgent tracheotomy is critical for airway obstruction management.
- Delays in urgent tracheotomy can lead to adverse patient outcomes.
- Institutional and system-level factors significantly impact timely airway intervention.
Purpose of the Study:
- Identify factors contributing to delays in urgent tracheotomy.
- Synthesize strategies to mitigate delays in airway emergencies.
Main Methods:
- A comprehensive scoping review was performed.
- Searched multiple databases (MEDLINE, Embase, Scopus, Web of Science, Google Scholar) up to June 2024.
- Included adult patients undergoing urgent tracheotomy for malignancy or infection, excluding other causes of airway obstruction.
Main Results:
- Three studies involving 531 patients were included.
- Common symptoms included dyspnea and stridor; indications were malignancy and deep neck infection.
- Delays stemmed from operating room access, staffing, and coordination issues. Complication rates ranged from 8-28%.
Conclusions:
- Urgent tracheotomy for malignancy or infection is time-sensitive.
- Institutional barriers significantly influence procedure delays.
- Standardized protocols, staffing improvements, simulation training, and rapid-response teams are key strategies to improve readiness and outcomes.
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