Emergency Tracheostomy under Local Anesthesia

Overview

A practical and academic shift-card approach to awake tracheostomy as a rescue decision in a threatened upper airway, when oral or nasal intubation is unsafe, unreliable, or anatomically impossible, but the patient is still breathing enough to preserve consciousness and airway tone. This is not merely a “neck procedure”; it is a timing decision: do we still have minutes for an organized awake tracheostomy, or have we entered a CICO scenario where immediate front-of-neck access is required? The goal is not simply to open the neck quickly. The goal is to avoid wasting the last...