Percutaneous dilatational tracheostomy is a common bedside procedure in an intensive care unit. Historically, a technique using bronchoscopic guidance is used. We describe here a new version of this technique in which ultrasound is used to lower the chance of vascular damage and ensure proper placement of the cannula in the midline position at the optimal level. We describe the protocol we use for this intervention at our institution and review the evidence for the feasibility and safety of ultrasound-guided percutaneous dilatational tracheostomy.
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