Abstract
Abstract:
Introduction:
Percutaneous tracheostomy has replaced surgical tracheostomy by its low incidence of complications and the rapidity with which the procedure can be performed at the bedside avoiding transport of critically ill patients to the operating rooms. Since it is a blind approach and it is an important technique with which intensive care doctors should be familiar although a variety of approaches have been described,

METHODS:
This study as conducted at King Hussein Medical Center Jordan Amman.
From December 2008 until November 2010 we present 22 patients who demonstrate the benefits of Fibro optic bronchoscope-assisted percutaneous tracheostomy.

The Fibro optic bronchoscope affords excellent visibility throughout the procedure, and reducing the risk of posterior tracheal wall perforation or damage to tracheal stents if present
We suggest that bedside fibro optic bronchoscope to assist percutaneous tracheostomy should be considered for selected patients, e.g. those who have had a previous tracheostomy, abnormal neck anatomy due to previous surgery or radiotherapy risk of difficult airway or bleeding, or existing tracheal stents.

Result:
• Successful tracheostomy was performed in each patient without complication. The duration of the procedure was20–30 (median 25) min. The fibro optic bronchoscope-guided percutaneous tracheostomy technique provided excellent visibility and support protecting the tracheal stents from displacement or damage during the procedure.

Discussion:
Tracheostomy for long-term management of airway and ventilator problems is a recognized technique and percutaneous insertion of a tracheostomy tube was described by Sheldon and colleagues(1) in 1955. Complications arising from this procedure include hematoma formation and subsequent compromise of a patent airway, external bleeding, bleeding into the trachea, and formation of false airway passages and displacement of tracheal stents.

Keywords:
Percutaneous tracheostomy, fibro optic bronchoscope ,anesthetic techniques,

Key words: Keywords: Percutaneous tracheostomy, fibro optic bronchoscope ,anesthetic techniques,