Part of performing a bedside percutaneous tracheostomy is the procedural documentation. Given that this is a surgical procedure, the documentation should be more thorough than you may be accustomed to doing for an arterial line or central line.

I have included a sample procedure note below. Of course this should be adapted to the actual procedure you perform.

PERCUTANEOUS DILATIONAL TRACHEOTOMY WITH BRONCHOSCOPIC GUIDANCE

PATIENT NAME
AGE GENDER
DOB
MRN
Date of procedure

Performed by: Doctor 1, MD.
Bronchoscopy Assistant: Doctor 2, MD.
Nurse: Name, RN.
Respiratory Therapist: NAME, RT.

Indications: Chroni