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Open bedside tracheotomy in the intensive care unit
Author(s) -
Wang Steven J.,
Sercarz Joel A.,
Blackwell Keith E.,
Aghamohammadi Mazda,
Wang Marilene B.
Publication year - 1999
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-199906000-00009
Subject(s) - tracheotomy , medicine , percutaneous , incidence (geometry) , intensive care unit , surgery , endotracheal tube , emergency medicine , intensive care medicine , intubation , physics , optics
Objective : To demonstrate that open bedside tracheotomy is an efficient, safe, and cost‐effective procedure. Study Design : Retrospective review of more than 200 open bedside tracheotomies performed at UCLA Medical Center, Harbor‐UCLA Medical Center, and West Los Angeles VA Medical Center from 1995 to 1998. Methods : The only personnel required for the procedure were an attending or senior resident and a junior resident or intern, as well as the respiratory therapist to withdraw the endotracheal tube. No anesthetist or scrub nurse was present for any of the procedures. The procedure took an average of 15 to 25 minutes. Patients were followed for 30 days after surgery to determine the incidence of complications. Results : The incidence of major complications related to the procedure, including hemorrhage and myocardial infarction, was less than 1%. The incidence of minor complications, including moderate bleeding at the tracheotomy site, was 4%. Overall mortality within 30 days was 8%, but was not related to the tracheotomy for any patients in this series. The charge for the procedure was $233 for the tracheotomy tube supplies and instruments. This cost compares favorably with an average charge of more than $3000 for the procedure in the operating room and about $1000 for a percutaneous tracheotomy kit. Conclusion : Review of our experience demonstrates that open bedside tracheotomies can be performed more efficiently and economically than operating room tracheotomies. The safety of this procedure is comparable to percutaneous tracheotomy but at a decreased cost. Key Words : Tracheotomy, percutaneous tracheotomy