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PTD percutaneous dilational tracheostomy
Any rads doing these procedures?
technique is seldinger
general surgeons do them where I am now. -
10 Replies
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In the first covid wave my ir colleagues got stuck doing them in the long haul vented patients because nobody else would touch them, then the hospital was shocked when all the ir docs, nurses, and techs were out with covid and nothing else could get done.
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Wow, my interest in this is zero.
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Quote from wernicke
Wow, my interest in this is zero.
Surgeons seem to want it.
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In our practice the IR case volume has gone up and most of these are lines and tubes. ICU Used to do a lot of them but now they ask IR to do them.
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Our TRACS team did them. Surgery resident under attending supervision. Then ENT got all huffed up that this was their bailiwick and elbowed the surgeons our of the way by whining to the credentialing committee. 6months in they realized that this is a bedside procedure that pays like shit. So they quietly handed it back to the surgeons who are in the ICU all day for trauma care and would do those in between other small procedures like art-lines and chest tubes.
Good times.
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Quote from fw
Our TRACS team did them. Surgery resident under attending supervision. Then ENT got all huffed up that this was their bailiwick and elbowed the surgeons our of the way by whining to the credentialing committee. 6months in they realized that this is a bedside procedure that pays like ****. So they quietly handed it back to the surgeons who are in the ICU all day for trauma care and would do those in between other small procedures like art-lines and chest tubes.
Good times.
ENT definitely doesn’t have a monopoly on this procedure everywhere I have been- and I’ve been around.
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RVU Components (by modifier) modifier
work 6
practice expense 2.29
malpractice expense 1.01
total (none) 9.3seems decent
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Peg and trach go hand in hand. If you do one might as well learn the other.
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My underseanding was perc trachs were mostly handled by intervnetional pulm, but they all got moved to supervising redeployed doctors in the makeshift icus. Then the surgeons werent going to do open cases on 70/80 year old “survivors” with shot lungs so IR “won” the buisness of a swarm of perc trachs and g tubes. Also seemed like a big uptick in of chole tubes for acalc chole.
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Quote from CaptainWaffles
In the first covid wave my ir colleagues got stuck doing them in the long haul vented patients because nobody else would touch them, then the hospital was shocked when all the ir docs, nurses, and techs were out with covid and nothing else could get done.
They never did them before and then were asked to do them by administration? Sounds odd.
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