Tracheotomy

A. Patient in supine position for tracheostomy. The neck is extended on a shoulder roll. Note position of skin incision (line).
B. Vertical insicsion in trachea. Note lateral stay sutures to be used in the event of accidental decannulation.
C. Tracheostomy tube is inserted into trachea.
D. Tracheostomy tube secured with neck ties.

Source: The Care of Children with Long-Term Tracheostomies, Edited by Ken M. Bleile. Surgical Management of the Tracheostomy, by Steven D. Handler