Surgical procedure that creates an opening in the anterior neck at the cricoid cartilage leading directly to the trachea; opening usually referred to as a tracheostomy (see Tracheostomy tube placement)

Indicated for children requiring long-term ventilation or for those with epiglottiditis, croup, or foreign body aspiration

May performed in emergency departments when endotracheal intubation isn’t possible, in the field where immediate intervention is necessary, or in the more controlled setting of the operating room

To provide an airway for an intubated child who needs prolonged mechanical ventilation and to facilitate the removal of lower tracheobronchial secretions in a child who can’t clear them

To prevent an unconscious or paralyzed child from aspirating food or secretions and to bypass upper airway obstruction due to trauma, burns, epiglottiditis, or a tumor

For an emergency tracheotomy, briefly explain the procedure to the child and his parents as time permits and quickly obtain supplies or a tracheotomy tray.