Open tracheostomy - YP

The patient was met in the surgical ICU, patient, consent, site and procedure to be performed confirmed. The patient was transported to the operating room and placed on the table in supine position. General anesthesia was induced and was already intubated. The patient was secured to the table with straps and all boney areas padded. A shoulder roll was placed. A timeout was done and all were in agreement.

The neck was prepped with Betadine and draped in normal sterile fashion. A curvilinear incision over the expected location of the 1st and 2nd tracheal ring was made. The incision was carried down through the platysma. The strap muscles were identified and retracted laterally and preserved. The thyroid isthmus was retracted superiorly and preserved. The trachea was identified. A tracheal hook was used to lift the trachea and expose the 2-3rd tracheal ring. The anesthesia team deflated the balloon, reduced the Fi02. An tracheotomy was created with 15 blade and dilated with tracheal dilator. 2-0 Prolene stay sutures were placed in the superior and inferior aspect of the tracheotomy. The ET tube was retracted just above the level of the tracheotomy. A lubricated 7.5 cuffed Portex tracheostomy tube was placed. It was connected to the anesthesia circuit and there was return of end-tidal CO2. The tracheostomy wings were secured to the skin with 2-0 nylon. The stay sutures were secured to the chest and neck with Steri-Strips. All counts were correct.