Per-cutaneous dilatation tracheostomy (PCTD) in COVID-19 patients and steps to prevent Aerosolisation: A Case Series.

• COVID 19 patients with severe respiratory failure may require prolonged mechanical ventilation. Placement of a tracheostomy tube often becomes necessary for such patients. • The steps of tracheostomy procedure and post tracheostomy care of these patients can be classified as aerosol generating. • We performed percutaneous dilation tracheostomy in three clinically challenging COVID-19 patients in our ICU. • We developed guidelines aiming to minimise aerosolisation during and after the tracheostomy procedure to safeguard healthcare workers. Percutaneous tracheostomy was performed by a team of three experienced anaesthetists and an ICU nurse. • The decision of surgical or percutaneous tracheostomy should be dependent on the experience of the tracheostomy performer, health-care worker safety, resource availability, and patient-centred care. We believe our modified strategic approach for PCDT offers an extra level of safety to healthcare workers.