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5.1.5 - Percutaneous Tracheostomies and Management of Tracheostomy Emergencies
from Section 5.1 - Practical Respiratory System
- By Ramprasad Matsa
Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
Book:

Intensive Care Medicine

Published online:

27 July 2023

Print publication:

01 December 2021, pp 538-543
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Summary

Key Learning Points
1. Percutaneous dilatational tracheostomy (PDT) is generally a safe procedure when performed appropriately, and may be conducted in the intensive care unit setting, thereby avoiding a needless transfer to the theatre facility.
2. The single dilator technique is the most commonly used method to perform percutaneous tracheostomy in the UK.
3. The use of fibreoptic bronchoscopy and ultrasound guidance has increased the procedural safety and decreased failure rates.
4. Education and training in tracheostomy emergency management are mandatory and should remain as part of the governance policy.
5. Adequate humidification and regular suctioning are important components of the post-tracheostomy management, and both have been shown to reduce the subsequent complication rates.