Checklist for percutaneous tracheostomy

1. Checklist for percutaneous tracheostomy • Pre withdrawal of ETT • Team brief • Name and role • Operator • Bronchoscopy • Airway assistant • Runner • Check patient • Consent • Relatives informed • Check contraindications • Clotting and platelets • Airway anatomy (USS) • Level of ventilator support • Feed off/aspirated • Equipment check • Tracheostomy kit • Sandbag • Airway equipment • Bronchoscope • Monitoring • Emergency drugs • Post procedure • Satisfactory position • Position confirmed with capnography • Position confirmed using bronchoscope • Tracheostomy secured • Equipment • Have we accounted for the sharps used? • Is the inner tube in place? • Spare inner tube saved? • Records • Who will record procedure and what complications should be recorded? • Who will complete the bed head sign? • Patient • Sedation weaning plan • Ventilation weaning plan • Re-start feed • Bed head sign attached to wall • Time Out – immediately prior to procedure starting • 100% Oxygen • Adequate sedation • Muscle relaxation given • Mandatory ventilator mode • Capnography in-situ • Positioning • Local anaesthetic to neck • Plan for procedure • Anticipated problems • Back-up plan RiCON Trachy checklist RBH