Guidance
The National Institute for Health and Care Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Translaryngeal tracheostomy (TLT), in August 2013.
Description
Tracheostomy is commonly carried out for patients in intensive care to maintain their airway, to remove excessive airway secretions and to enable them to be weaned from mechanical ventilation. This may be performed surgically but anaesthetists and intensive care physicians usually perform the procedure using a percutaneous technique, inserting a tube from the outside of the neck into the trachea, using a various devices and, commonly under endoscopic guidance.
The translaryngeal tracheostomy technique may lead to lower rates of bleeding, trauma and infection to the tissues surrounding the insertion area, compared with surgical and other percutaneous techniques. It may also avoid the risk of damage to the posterior wall of the trachea and tracheal rings, because of a lack of external compression during insertion.
Coding recommendations
E42.3 Temporary tracheostomy
Y76.3 Endoscopic approach to other body cavity