PMC3968651_01
Percutaneous tracheostomy set (cook critical care)
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F1
Under aseptic conditions, PDTK was opened [Figure 1].
(a) Insertion of needle with cannula. (b) Passing guide wire and sheath through cannula
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F2
We passed the Seldinger needle either (1) in the mid submental region (submental approach) just inferior to the lower border of the mandible or (2) in the paramedian submental region, directly adjacent to the medial aspect of the lower border of the mandible (transmylohyoid approach) depending on the surgical need as shown in Figure 2a. Over the guide wire, we passed successively large serial dilators starting with the white introducer through the skin into the oral cavity as shown in the Figures 2b and 3a.
(a) Insertion of needle with cannula. (b) Endotracheal tube brought out
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F3
Over the guide wire, we passed successively large serial dilators starting with the white introducer through the skin into the oral cavity as shown in the Figures 2b and 3a. While stabilizing the tracheal end of tube with one hand, the proximal end of the tube was brought out through the oral cavity as shown in Figure 3b.