Building a Tracheostomy Instrument Set for ICU and Theatre

Core contents of a tracheostomy set list

A tracheostomy set list usually follows the sequence of the procedure: skin incision, dissection of the strap muscles, exposure of the trachea, opening of the airway and tube insertion. The instruments therefore split into cutting, holding, retracting and suturing groups, and a well-designed set keeps each group together in the tray.

Departments that perform open tracheostomy regularly tend to standardise on one set rather than assembling instruments case by case. This reduces counting errors and shortens turnover, which matters in a unit where the same tray may be reprocessed several times a week.

• Scalpel handle and blades for the skin incision
• Dissecting scissors and fine tissue forceps
• Haemostatic forceps (mosquito and Kelly type) for small vessels
• Small self-retaining or hand-held retractors
• Tracheal hook and tracheal dilator
• Needle holder with suture scissors

Tracheal dilator and tracheal hook: what each does

A tracheal dilator holds the tracheal opening apart while the cannula is introduced. Two-bladed dilators in the Trousseau or Laborde style are the traditional patterns; the useful questions for a buyer are blade length, blade smoothness and whether the spring or screw action opens evenly without catching the tracheal ring.

The tracheal hook is a single-pronged sharp or blunt hook used to lift and stabilise the cricoid or tracheal ring so the surgeon can incise with control. Both instruments contact the airway directly, so surface finish and the absence of burrs on the tips are more important than the overall size of the instrument.

Retractors, haemostats and sutures

The neck is a narrow field, so retractors should be small and light. Hand-held retractors in the Langenbeck and Farabeuf family give an assistant fine control of the strap muscles, while a small Weitlaner type frees the assistant's hands. REDA lists these patterns in its retractors range, and the same manufacturer's general surgery section covers probes, grooved directors and suture needles that complete the tray.

For vessel control, fine haemostatic forceps are used on thyroid isthmus branches and anterior jugular veins. The differences between patterns are explained in our guide to haemostatic forceps. Suturing is done with a standard needle holder; stay sutures on the tracheal wall are common, so the set should include enough needle holders and suture scissors for the team.

Tracheostomy instruments in the ENT range

REDA's ENT instruments section lists tracheotomy instruments alongside mouth gags, laryngeal instruments and McIntosh and Miller laryngoscope blades. Because the airway and the instruments for managing it are in one catalogue, a purchaser can assemble a tracheostomy tray and an airway trolley from a single manufacturer.

The catalogue should always be checked pattern by pattern against the clinical team's preference. Surgeons trained in different centres often prefer different dilator and hook designs, and asking them to sign off the exact list before ordering avoids replacement requests later.

Specifying and reprocessing the set

Ask the supplier for material and finish information, the manufacturer's reprocessing instructions and the applicable quality system certification. Instruments with box joints and ratchets must be opened and lubricated according to the instructions before steam sterilization, in line with ISO 17665 practice. Keep dilators and hooks in a protected tray position so the tips are not damaged.

For a UAE facility, confirm current device registration requirements with the relevant authority and your licensing body before purchase. If you would like a tracheostomy tray configured for your ICU or theatre, Beckfinity's specialists can prepare a quote from the manufacturer's catalogue.