Percutaneous tracheostomy kit

This image depicts a Ciaglia Blue-Rhino tracheostomy tray with aligned tools in sequential order. From left to right, bottom row: seen are the chloraprep sponge, syringe containing lidocaine with epinephrine and attached 25 gauge needle, scalpel, forceps (for soft tissue dissection), second syringe containing the same drug, and an introducer needle with plastic cannula for the guidewire insertion. Next, is the guidewire with a small punch tracheal dilator (seen within the circular holder), a curved single tapered large dilator ("Blue-Rhino") with an extended white guide catheter (note that the tracheostomy cuffed has been checked in a saline bowl and tapered with lubricant and the proper size blue loading dilator is already placed inside the tracheostomy tube). A needle holder with suture and "4x4" split drain sponge are next. Upper row: Blue sterile saline bowl and gauze are seen; the tracheostomy inner cannula, trocar, and endotracheal adaptor are seen below the gauze. Other smaller loading dilators are located in the tray in the left upper corner of the picture. Finally, tracheostomy ties are seen in the far right of the picture.