Intubation of the human trachea has been performed since ancient times, a tracheostomy being one of the earliest surgical procedures known. A tracheostomy is a surgical opening in the anterior wall of the trachea to facilitate breathing. The tube enables airflow to enter the trachea and lungs directly, thus bypassing the pharynx and larynx. Intensive Care Society guidelines state that within the first 24 hours post procedure the patient should be cared for in a High Dependency environment (ICS 2000). Debate continues concerning the indication, timing and alternative methods of tracheostomy.