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Percutaneous tracheostomy: don't beat them, join them.

D Russ Blankenship1, Christine G Gourin, W Bruce Davis

  • 1Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia, Augusta, GA, USA.

The Laryngoscope
|October 12, 2004
PubMed
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A collaborative approach to bedside percutaneous tracheostomy (PercTrach) between otolaryngology and pulmonary/critical care specialists offers clinical and educational benefits. This multidisciplinary method ensures rapid, cost-effective elective tracheostomy procedures.

Area of Science:

  • Critical Care Medicine
  • Otolaryngology
  • Surgical Procedures

Background:

  • Percutaneous tracheostomy (PercTrach) has created scope of practice disputes between otolaryngologists and pulmonary/critical care (PCC) specialists.
  • A collaborative approach may resolve these tensions and improve patient care.

Purpose of the Study:

  • To evaluate the value of a collaborative, multidisciplinary approach to bedside percutaneous tracheostomy (PercTrach).
  • To assess the efficiency and benefits of joint otolaryngology and PCC team performance of PercTrach.

Main Methods:

  • Retrospective review of 23 consecutive bedside PercTrach procedures performed between May and November 2003.
  • Procedures were conducted collaboratively by otolaryngology and PCC teams, with PCC typically providing bronchoscopic guidance.

Related Experiment Videos

  • The Ciaglia Blue Rhino introducer set was used for all PercTrach procedures.

    • Main Results:

    • The mean procedural time for PercTrach was 13.9 minutes.
    • The average time from consultation to PercTrach was 41.7 hours, with most delays due to patient stability.
    • No specific complications were detailed in the results, but the procedure was performed efficiently.

    Conclusions:

    • A multidisciplinary approach to PercTrach yields significant clinical and educational advantages.
    • This collaborative method facilitates a rapid and cost-effective response for elective tracheostomy requests.
    • Otolaryngologists are encouraged to consider this revised, team-based approach to PercTrach.