Table 1 Proposed checklist before percutaneous dilatational tracheostomy (pre and post)

Preption

Confirm patient’s consent or next of kin’s assent

Is the neck anatomy favourable (no previous surgery or radiotherapy?)

Ultrasound of the neck performed? (Midline/abnormal vessels absent?)

FiO₂ requirement <70 %, PEEP <10 mm Hg

Is coagulation okay? (Platelets >80,000/μl, INR <1.5, APTT <45 seconds)

Anticoagulants and antiplatelets withheld?

Gastric feeding suspended?

Procedure

Airway management and anaesthesia: Dr ……………………………………………………

Tracheostomy: Dr…………………………………………………………

Minimum monitoring (ECG/SpO₂/NIBP/EtCO₂)

Airway rescue equipment available?

General anaesthesia (propofol + opioid) and plysis (atracurium)

20 ml local anaesthesia – 1 % lignocaine with adrenaline

Ciaglia dilatational tracheostomy (preferably with subglottic suction). A range of tube sizes and adjustable flange tube should be available

Airway toilet/suction and bronchoscopy

Tracheostomy position is confirmed by EtCO₂ and bronchoscopy

Tracheostomy is secured with sutures and tapes, and inner cannula inserted

Post procedure

Check chest X-ray satisfactory?

Document in the clinical record

Review sedation and ventilation