Related Experiment Video
Updated: Oct 13, 2026

The Rigid Tube as an Alternative in Controlling the Problematic Airway
Published on: June 6, 2020
Griggs percutaneous tracheostomy without bronchoscopic guidance is a safe method: A case series of 300 patients in a
Saroj Kumar Pattnaik1, Banambar Ray1, Sharmili Sinha1
1Department of Critical Care Medicine, Apollo Hospitals, Bhubaneswar, Odisha, India.
Introduction:
Percutaneous tracheostomy (PCT) is being increasingly done by intensivists for critical care unit patients requiring either prolonged ventilation and/or for airway protection.[1] Bronchoscopic guidance considered a gold standard,[23] is not always possible due to logistic reasons and ventilation issues. We share our experience of Griggs PCT technique without bronchoscopic guidance with simple modifications to ensure safe execution of the procedure.
Objective:
The purpose of this study was to evaluate the safety issues and complications of PCT without bronchoscopic guidance in a multi-disciplinary tertiary Intensive Care Unit (ICU).
Materials And Methods:
A retrospective review of consecutive PCTs performed in our ICU between August 2010 and December 2013 by Griggs guide wire dilating forceps technique without bronchoscopic guidance is being presented. It is done by withdrawing endotracheal tube with inflated cuff while monitoring expired tidal volume on ventilator and ensuring the free mobility of guide wire during each step of the procedure, thereby ensuring a safe placement of the tracheostomy tube (TT) in trachea.
Results:
Analysis of 300 PCTs showed 26 patients (8.6%) had complications including 2 (0.6%) patients deteriorated neurologically and 2 (0.6%) deaths observed within 24 h following procedure. The median operating time was 3.5 min (range, 2.5-8 min). There were no TT placement problems in any case.
Conclusion:
Percutaneous tracheostomy can be safely performed without bronchoscopic guidance by adhering to simple steps as described.
Related Concept Videos
Oxygen Delivering System III: Tracheostomy and T-piece
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
Tracheostomy: Procedure and Tubes
Tracheostomy tubes can be made of semiflexible plastic (polyurethane or silicone), rigid plastic, or metal, and they come in...
Tracheostomy Care I: Pre-procedural Steps
Required Equipment
The equipment necessary for tracheostomy care includes:
Endotracheal Intubation I: Procedure
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
Tracheostomy Care II: Procedure
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask and...
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques

