Tracheostomy Evaluation
Original Date: 02/2020 | Last Review Date: 03/2024
Purpose: To standardize the preoperative work up of patients being considered for tracheostomy.
Tracheostomy Evaluation
Upon request or consultation for tracheostomy:
- Assess current ventilatory support
- Minimum ventilatory support acceptable for tracheostomy is highly provider dependent.
- Check with surgeon for whom tracheostomy is planned if ventilatory settings are appropriate for tracheostomy.
- Review cervical spine precautions:
- Patient in cervical collars will have tracheostomies performed in operating room
- Patients with no cervical spine precautions are potential candidates for percutaneous tracheostomy at the bedside
- Review recent available CT Chest or CTA Neck:
- Innominate artery below sternal notch, proceed with open or percutaneous tracheostomy as otherwise indicated
- Innominate artery above sternal notch
- Ensure tracheostomy is required for patient care
- If required, plan open tracheostomy in operating room with muscle flap between the tracheostomy and innominate artery