Modifications to forming a tracheostomy
| Example | Quotation |
| Being performed only by a small team of experts | HP43: Early on, I was interested in working [on tracheotomies] and a surgeon was interested in it as well. Our personalities work reasonably well together and we started, from the surgical side at least, combining forces and trying to figure out a way to do this safely… We weren't exactly sure which patients were going to make the most sense. We didn't know who exactly would benefit from it, but there was little question there were going to be some people … We go into the room, we wheel in all our stuff. We don't even talk that much anymore. Teamwork is very crucial… I think it has been important, both from an operational standpoint, but also from a mental support and enthusiasm standpoint. I think, if one of us was doing this alone, without the other, I think it would be a lot more difficult. I wouldn't say it’s undoable on your own completely, but it’s just crazy to try to do that. You have to ask for help. |
| Pausing the ventilator | HP41: I think a tracheotomy is more risk… Before we cut open, cut open the trachea, we make the ventilator pause for a second. Then first we pause the ventilator, then we cut, and then we insert the intubation quickly, and we restart the ventilator … If the ventilator is open, then there are a lot of aerosols… Secretion maybe comes out from the lungs, from the bronchia. So if we pause the ventilator, maybe they can decrease the secretions. |
| Location of tracheotomy | HP41: All the tracheotomy is at the bedside. So it’s including a resident, to help at the head side of the patient, and two surgeons. One is at the bedside, to do the surgery. And one or two nurses help to deliver some things to help the surgery. Now, the unit is the ICU unit. There’s one person per room. |
ICU, intensive care unit.