| Essential check points |
| There is no emergency response or any procedure without proper staff protection Availability of complete personal protective equipment for all professionals involved in contact with the patient: masks type PFF2 or N95, face shield; long sleeve waterproof and disposable gown The team must be composed of at least: surgeon, surgical assistant, nursing technician and anesthetist or intensive care physician (who will be responsible for the control of ventilation and management of the orotracheal tube) Working and tested auxiliary surgical light Working and tested electrocautery Working and tested suction Instruments for tracheostomy, tracheostomy cannulas with probable numbers (at least two cannulas of sequential numbers) 100% FiO2 and 5 cm H2O PEEP ventilation prior to procedure Checking the complete sealing of the orotracheal cannula cuff and positioning it distally to the tracheostomy site Complete patient sedation using hypnotic agent, opioid and neuromuscular blocker (in charge of the anesthetist or intensive care physician) No use of electrocautery on the trachea Mechanical ventilation in PAUSE mode and clamped orotracheal tube for extubation Tracheostomy cannula preferably already connected to the closed suction system and with a filter installed when introduced into the trachea |