Percutaneous tracheostomy is now a well estabished technique used in the critical care setting. In general it is an elective procedure, and not suitable for the emergency airway, although this has been described.

Although the technique may be performed blind, whenever possible the trachea should be visualised via an intubating fibreoptic laryngoscope passed down the tracheal tube. Two operators are required for the procedure, one performing the tracheostomy, and one at the head of the patient looking after the airway, anaesthesia and bronchoscopy.