The technique of minitracheotomy to clear secretions. Gain direct access to the trachea; preserve cough and speech.

Abstract

Minitracheotomy, a new method of percutaneous tracheal cannulation, provides ready access to the trachea for removal of airway secretions in spontaneously breathing patients with sputum retention and atelectasis. The original technique calls for a vertical 1-cm stab incision over the cricothyroid membrane; a curved introducer is then passed through this incision into the trachea. A cannula is passed over the introducer, which is then removed. The external flange is secured to the patient's neck. A modified technique uses a Seldinger method for tube placement. Complications vary with the technique that is used; cough, subcutaneous emphysema, stridor, and rare instances of profuse hemorrhage have been reported.