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 Indication for tracheostomy: failed weaning/extubation, relief of airway obstruction or secretions.

 Review surgical history for prior neck surgery, tracheostomy, or radiotherapy to the anterior trachea/neck.

 Hemodynamic stability, stable cardiac condition.

 Lack of bleeding, intact coagulation profile (preferably INR <1.5 and platelet count >50 000).

 Absent severe sepsis.

 In making the decision for PDT, it is important to keep in mind that this is an otherwise elective procedure so care must be taken to avoid potential complications.