Bedside video-assisted percutaneous dilational tracheostomy

The majority of complications with percutaneous dilational tracheostomy (PD T) occur by erroneous needle puncture and insertion of the guidewire into t he tracheal lumen. The present report describes a modification of the stand ard PDT in which the needle puncture and the following steps for the introd uction and placement of the tracheostomy tube are video-assisted by the use of a laryngofiberscope. The direct visualization of the median needle punc ture of the trachea by this technique decreases the risks and failures asso ciated with the procedure.