Developing a tool for assessing and communicating the expected difficulty of performing a tracheostomy.

Area of Science:

• Anesthesiology
• Surgical Sciences
• Critical Care Medicine

Background:

• Current lack of standardized guidelines for assessing tracheostomy difficulty hinders effective planning for percutaneous approaches in intensive care and surgical referrals.
• This deficiency complicates interdisciplinary communication between critical care and surgical teams.

Purpose of the Study:

• To develop a universally applicable tool for assessing and communicating the expected difficulty of tracheostomy procedures.
• To create a common language and set of metrics for both intensive care and surgical specialists.

Main Methods:

• A Delphi process was employed to achieve consensus among experts.
• Key metrics relevant to both percutaneous and open tracheostomy approaches were identified and validated.

Main Results:

• Several relevant metrics were identified, including palpable tracheal rings, history of anterior neck surgery or radiotherapy, uncorrectable clotting or platelet dysfunction, neck extension capability, and the presence of overlying vessels (visible, palpable, or on imaging).
• These metrics are universally assessable by both intensive care and surgical teams.

Conclusions:

• The developed tool provides a standardized method for assessing tracheostomy difficulty.
• Implementation of this tool is expected to improve communication and planning between critical care and surgical specialties, ultimately enhancing patient care and procedural safety.