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 The bedside percutaneous dilational tracheostomy (PDT) with a minimal tracheostomy incision utilizes the Seldinger technique and gradual dilation to insert the tracheostomy.

 PDT is a safe procedure in the critical care setting and should be first choice when available. Its use is more cost‐effective and trends towards fewer complications compared with open surgical tracheostomy.

 Proper selection of the bedside candidate requires a hemodynamically stable patient with no bleeding diatheses and normal neck anatomy.

 PDT is associated with less bleeding than open tracheostomy. Patients on anticoagulation or with severe derangements of INR or platelet count may either be supplemented with the appropriate blood products or deferred until stable for the procedure.

 Bronchoscopic guidance is often used during bedside tracheostomy procedures, but is not routinely required since it has not demonstrated better outcomes. Those not routinely using a bronchoscope may reserve its use for difficult cases.