The ‘blinking frog’ ultrasound sign establishes the presence of pretracheal vasculature
Percutaneous dilatational tracheostomy is a common bedside procedure in intensive care units (ICUs) worldwide. A feared complication of the procedure is bleeding. Ultrasound guidance during percutaneous dilatational tracheostomy can reduce the risk of bleeding by identifying the presence of vasculature in the pretracheal or paratracheal regions and is recommended in recent guidelines.
In conclusion, the ‘blinking frog’ ultrasound sign establishes the presence of pretracheal vasculature and is a relative contraindication to tracheostomy at this particular part of the trachea. A higher or lower puncture location should be considered.
PRT, DW, SS and HT contributed substantially to the study design and the writing of the manuscript.
Compliance with ethical standards
Conflicts of interest
The authors declare they have no conflict of interest relevant to this manuscript
The Commission for Medical Ethics (METc) of VUmc has approved this research: METC: 2016.053.
Written informed consent was given by the family of the patient.
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