Percutaneous Tracheostomy & Cricothyroidotomy
Includes pre-procedure assessment, bronchoscopic guidance, stepwise dilation, troubleshooting, post-procedure care, and when to favor surgical approaches.
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Exam mapping & scope
This chapter covers indications, contraindications, patient selection, pre‑procedure evaluation, technique, troubleshooting, complications, and post‑procedure care for percutaneous dilational tracheostomy (PDT/PT) and cricothyroidotomy. Emphasis is placed on bedside decision‑making in the ICU, device options and steps, guidance modalities (bronchoscopy and ultrasound), anticoagulation/antiplatelet management, special populations (obesity, high ventilatory support, coagulopathy, ECMO/COVID), and emergency “can’t intubate, can’t oxygenate” (CICO) rescue with needle, surgical, or percutaneous cricothyroidotomy.
Focus this round
- Patient selection
- Bleeding control
- Emergency rescue
Orientation
Target audience: IP fellows and practicing pulmonologists Blueprint section: Interventional airway—tracheostomy (percutaneous vs surgical), emergency surgical airway (cricothyroidotomy)
Interactive chapter
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