The Parkland 12-Minute Checklist Tracheotomy

J Oral Maxillofac Surg. 2016 Mar;74(3):556-61. doi: 10.1016/j.joms.2015.10.022. Epub 2015 Nov 6.

Abstract

Purpose: To validate the surgical time and propose a new checklist or algorithm to execute a tracheotomy within 12 minutes with optimal outcomes.

Materials and methods: The authors designed and implemented a checklist method for tracheotomy based on 6 consecutive patients with respiratory failure and prolonged intubation in a medical intensive care unit. The primary outcome variable was surgical time for a tracheotomy performed by a fifth- or sixth-year resident under the supervision of the senior author (M.Z.).

Results: Six consecutive patients undergoing tracheotomy (mean, 48 yr; range, 24 to 55 yr; 4 men and 2 women) were included in the study. The average time recorded from the incision to correct insertion of the tracheotomy tube and confirmation of carbon dioxide return by the anesthesiologist was 10.66 minutes (range, 8 to 12 minutes).

Conclusion: This checklist facilitates the execution of a time-efficient and safe tracheotomy in less than 12 minutes.

MeSH terms

  • Adult
  • Algorithms
  • Anatomic Landmarks / anatomy & histology
  • Checklist*
  • Cricoid Cartilage / anatomy & histology
  • Critical Care
  • Dissection / methods
  • Electrosurgery / instrumentation
  • Female
  • Humans
  • Intubation, Intratracheal / instrumentation
  • Male
  • Middle Aged
  • Neck Muscles / surgery
  • Operative Time
  • Patient Positioning
  • Quality Improvement
  • Respiratory Insufficiency / surgery
  • Respiratory Insufficiency / therapy
  • Safety
  • Sternum / anatomy & histology
  • Subcutaneous Fat / surgery
  • Time Factors
  • Tracheotomy / instrumentation
  • Tracheotomy / methods*
  • Treatment Outcome
  • Young Adult