Percutaneous dilational tracheostomy: a safer technique of airway management using a microlaryngeal tube.

Management of the airway in an intubated patient during formation of a tracheostomy can be hazardous. The usual method involves withdrawal of the tracheal tube, which has been providing a secure airway, prior to inserting the tracheostomy tube. A method of airway management, using a microlaryngeal tube, has been devised with the aim of maintaining full tracheal intubation and ventilation until the correct position of the tracheostomy tube can be verified. An audit of 250 successive cases of percutaneous tracheostomy demonstrated this method to be safe and effective.