Percutaneous tracheotomy is generally performed
solely on intubated patients and, unlike surgical tracheotomy,
can be performed without direct visualization
of the trachea. Bronchoscopy is used to guide and
confirm placement of the tracheostomy tube within the
trachea and is considered standard of care.13 In contrast
to an open surgical incision, a small opening is created
with a needle and then dilated.13 Contraindications to
percutaneous tracheotomy include uncorrected coagulopathy,
infection at the incision site, high ratio of positive
end-expiratory pressure to fraction of inspired oxygen,
elevated intracranial pressure, tracheal obstruction,
unusual neck anatomy, and the need for emergency
airway management