Percutaneous tracheostomy: ready or not?

A novel approach to tracheostomy has recently been introduced, based on the Seldinger guide-wire technique. A well-packaged percutaneous tracheostomy kit promises a rapid and safe alternative to the traditional surgical tracheostomy. At the National Defence Medical Centre, this percutaneous approach was tried on four patients. Deficiencies in the kit instruments were discovered which, with the expected "learning curve," led to unexpected difficulties. Thus, the promise of percutaneous tracheostomy remains as yet unfulfilled.