Tracheotomy is a surgical procedure used to cut a hole in the trachea through which a small tube is inserted. Trachetomy is indicated when the airway is mechanically blocked, for example by a crushing blow to the neck, and efforts at both intubation and "popping" the trachea process back into shape with the thumbs have been unsuccessful.
Sometimes a planned tracheotomy is indicated when a patient requires long-term mechanical ventilation, for example in throat cancer. Great care must be taken to avoid damaging the vocal cords.
The emergency tracheotomy is performed only by doctors qualified in emergency medicine or under their specific direction. Paramedics perform a needle cricothoracotomy instead, if local protocols permit.
In wilderness first aid texts, the use of emergency tracheotomy has been discussed as a last-ditch method of opening an airway in persons with severe neck trauma. It should only be attempted if the only other alternative is the certain death of the victim, and the person attempting the procedure does not mind facing litigation and/or criminal charges even if successful.
See also mechanical ventilation intubation
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