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17[[quoteright:350:[[Manga/JoJosBizarreAdventureGoldenWind https://static.tvtropes.org/pmwiki/pub/images/screenshot_2020_12_27_015911.png]]]]
18[[caption-width-right:350:[[Music/TheScript I'm still alive, but I'm barely breathing...]]]]
19
20There seems to be a trend in Hollywood. If a scene is falling flat, add someone choking. But the Heimlich maneuver is boring and overplayed (and honestly just looks ridiculous). Wait, I know! He's not really choking, he's suffocating! And that means, instead of the boring, [[DoesThisRemindYouOfAnything vaguely erotic]] reach-around of the Heimlich, our heroes get to slice someone open.
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22Sometimes this is used to establish that a character has medical training. Sometimes a note of drama is added because the character performing the techniques does ''not'' have the training, but usually he's being talked through it by someone who does. Like other [[CPRCleanPrettyReliable Hollywood]] [[ShotToTheHeart medical techniques]], this often goes smoothly and without complications...even when performed by non-doctors.
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24On TV and in movies, this procedure commonly consists of stabbing someone in the throat using a ball-point pen with the ink tube removed. In real life, it would be quite difficult to use an empty pen to break through the skin and internal tissues all the way through to the airway, and you can't just jam it in anywhere. [[https://www.jems.com/patient-care/airway-respiratory/can-you-really-perform-an-emergency-cricothyrotomy-using-a-ballpoint-pen/ People were tested on their ability to do this,]] and only one out of ten participants was actually able to get the pen in the right spot and deep enough; it should be noted that this also took over five minutes, more than long enough for someone to suffocate. But if you know where to aim, and use a knife to make an incision first, [[TruthInTelevision a pen can indeed act as an improvised breathing tube]].
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26Supposedly, this has led to idiots trying this on people who collapse for reasons that have nothing to do with breathing. This is obviously something you do not want to do without the kind of training that results in a medical doctorate degree. A procedure as drastic as a tracheotomy should only be used as a last resort, since it basically boils down to [[SlashedThroat slitting someone's throat]], which can obviously make things worse if performed incorrectly. If it's at all possible, you shouldn't do this until after you've called an ambulance and are sure that it's an appropriate measure to take.
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28It's worth noting that in most cases, what the characters perform is not actually a tracheotomy but a cricothyrotomy.
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30Not to be confused with an ImpromptuTracheotomy, which is stabbing someone's neck as an attack.
31----
32!!Examples:
33[[foldercontrol]]
34
35[[folder:Anime & Manga]]
36* Seen in ''Manga/JoJosBizarreAdventureGoldenWind'': After Narancia's tongue was bitten off by an enemy Stand, he begins to choke, and so Giorno quickly uses the tube of a pen to stab Narancia in his neck so that he can breathe, until Giorno finishes healing his tongue.
37[[/folder]]
38
39[[folder:Comic Books]]
40* Franchise/{{Batman}}, to the surprise of no one, can perform tracheotomies. He does this at one point in ''All-Star Batman and Robin'' to save Hal Jordan's life.
41** In a ''Detective Comics'' story arc during MediaNotes/TheDarkAgeOfComicBooks, ComicBook/TheRiddler got his hands on a demon summoning ritual that had been performed by Gotham's founders, which called for the sacrifice of a "human bat," who was prepared for the sacrifice through a series of gruesome and bizarre ordeals, among them slitting the throat of a newborn baby. So he kidnapped a baby, shoved a ping pong ball in its mouth and left it for Batman to find as he made his escape.
42* In ''ComicBook/TheBoys'', [[NaiveNewcomer Wee Hughie]] gets trained to do this by TheLeader Butcher and ends up having to put it to use when ExtremeOmnivore Black Hole suddenly suffers PowerIncontinence and chokes on a plastic spoon.
43* In an issue of ''ComicBook/{{Deadpool}}'' (or possibly ''Agent X''), DeathTrap creator Arcade does this, much to everyone's surprise -- not just that he knew how, but that he'd bother.
44* Played for more drama than usual in one ''ComicBook/{{Diabolik}}'' story, as doctor [[OneShotCharacter Flavio Todd]] had to practice one on his daughter when she started suffucating for an allergic reaction to a medicine given to her by another doctor to deal with the aftermath of an abortion... But they're on a car and he's so shaken by what's happening to her ''and'' discovering she just had an abortion that he crashes, with her dying and him forgetting everything except that he sliced his own daughter's throat, pushing the doctor to ''demand'' potentially dangerous cures so he could remember and properly pay for what he thinks is his daughter's murder. When he remembers (and the reader finds out why he had sliced his daughter's throat), however, he decides to [[PapaWolf track down the man who prescribed to his daughter a medicine without checking her for allergy so he can murder him]].
45* In ''ComicBook/KnightsOfTheOldRepublic'' Slyssk needs to have one after being force choked. Justified, both since Slyssk is a Trandoshan with [[HealingFactor regenerative abilities]] that allowed him to survive, and the Mandalorian who performed the procedure [[spoiler:is actually a doctor in disguise]]. Rohlan admits that he likely would have died if it wasn't for his Trandoshan toughness.
46* ''ComicBook/TheMightyThor'': Thor actually does this during Dan Jurgens' run, when he's masquerading as Jake Olson, showing that he retains the medical knowledge of Doctor Donald Blake.
47* ''ComicBook/SensationComics'': Dr. Pat has to perform an emergency tracheotomy on a collapsed young mine worker who fell down a pit in the mine, which is where she got stuck starting his treatment.
48[[/folder]]
49
50[[folder:Film -- Live Action]]
51* In ''Film/{{Anaconda}}'', the team leader puts on some scuba gear and gets in the water to fix the motor, but is stung by a poisonous wasp which blocks his throat. He's quickly hoisted back on board and saved by Sarone, who performs an impromptu tracheotomy. [[spoiler:It's later revealed that he staged the entire incident to manipulate the crew to follow him to the Anaconda's feeding grounds and serve as bait.]]
52* In ''Film/{{Darkness|2002}}'', Creator/AnnaPaquin is instructed to do this in order to save her father's life. Subverted because [[spoiler: this is done in an attempt to make her unknowingly kill her father]].
53* "[[WorstAid Idiots trying this when they don't know what they're doing]]" is used for a fantastic subversion of ChekhovsSkill in ''Film/TheHeat''. Just as Ashburn is getting chewed out by her partner for always thinking she knows better than everyone else, a guy next to them in the diner starts choking. Ashburn, who had half-watched a medical programme about tracheotomies earlier in the film, springs into action... succeeding only in nicking an artery and spraying the diner with blood by the time the ambulance arrives.
54* David performed one in ''Film/JustLikeHeaven'' despite having no medical training. Elizabeth's quasi-ghost talks him through it.
55* ''Film/TheLastRitesOfRansomPride'': When bandits break into the church where they are sleeping, Champ catches a brutal blow to the throat from [[PistolWhipping a rifle butt]]. After the bandits are killed, Sergeant performs an emergency tracheotomy on Champ; explaining to Juliette that Champ's windpipe is filling with blood and if he doesn't relive the pressure, Champ will choke before they can get him to medical attention.
56* One character in ''Film/TheLegacy'' starts suddenly choking from a chicken bone during dinner. The Heimlich maneuver doesn't do anything, so the nurse of the house's owner proceeds to try to save his life with a tracheotomy operation.
57* In ''Film/MadMaxFuryRoad'', Max saves Furiosa from suffocation by puncturing one of her lungs in order to let air in.
58* In ''Film/NancyDrew'', the titular character performs this on a classmate who had allergic reaction at a party (the classmate, according to a friend, was "insanely" allergic to peanuts and had made out with a boy who had eaten a peanut butter cookie), much to the horror of the other partygoers--[[DontTryThisAtHome Nancy also warns her guests beforehand to not try anything she was about to do on their own unless they've had advanced emergency medical training]]. The movie plays with the idea that Nancy is always CrazyPrepared for emergencies--and thankfully, she does manage to save her classmate.
59* In ''Film/{{Nobody}}'', after Hutch crushes Teddy's windpipe, he apparently decides it's better to keep him alive than risk a murder investigation. He uses a knife and soda straw to give Teddy a tracheotomy which keeps him alive until the ambulance arrives. Unfortunately, between this and the rest of the beating he had taken, Teddy ends up in a coma with irreversible brain damage.
60* In ''Film/NurseBetty'', Betty successfully performs a tracheotomy, knowing how to do so from obsessively watching a medical soap opera.
61* In the German film ''Film/ThePrincessAndTheWarrior'' (2000), this is how the protagonists meet-- Bodo, after inadvertently causing Sissi to be hit by a truck, performs an emergency tracheotomy [[note]]presumably having learned how to do so during his time in the military[[/note]] on her and disappears before Sissi can learn his name. As a result, [[RescueRomance she becomes obsessed with tracking him down]].
62* ''Film/SawV'' has Strahm get his head locked inside a box that starts filling up with water. He survives by giving himself a tracheotomy with a ''pen''.
63* In the 2017 Korean thriller ''Film/SteelRain'', a fight between two North Korean intelligence operatives in a hospital apparently ends when one of them gets his windpipe crushed. However he grabs a [[LodgedBladeRecycling scalpel lodged in the neck of another operative]], uses it to cut open an IV tube and give ''himself'' a tracheotomy, then [[TheDeterminator races after the other operative]].
64* In ''Film/TheSweetHereafter'', a character narrates in flashback how he was prepared to do this to his infant daughter as she went into anaphylactic shock after being bitten by a spider. [[spoiler: Averted because in the end, he got her to the hospital before this was necessary]], and subverted in the sense that it was clear this was to be a last resort and his chances of performing it successfully were minimal.
65* Lane performs one in ''{{Film/Switchback}}'' to establish his character used to be in med school.
66* In ''Film/ThreeKings'', Mark Wahlberg's character suffers from pneumothorax (a collapsed lung) so his comrades have to puncture his lung to give him tension release. Watch it [[https://youtu.be/38rHuxIhf6I?t=102 here]] (gore alert).
67[[/folder]]
68
69[[folder:Literature]]
70* This trope is {{Lampshaded}} in ''Literature/{{Choke}}'' by Creator/ChuckPalahniuk. The protagonist frequently runs a con where he deliberately chokes on food to get strangers to perform the Heimlich on him; he is terrified that one day he'll encounter an idiot thinking of this trope coming after him with a steak knife and a ballpoint pen tube.
71* In ''Literature/CodexAlera'', this is performed on [[spoiler: Ehren]] when his throat is crushed by an earthcrafter's chokehold. Ambassador Varg quickly makes an incision with one of his razor-sharp claws and sticks a hollow writing quill into the cut to breathe with. This is stated to be only a temporary measure and that without proper care and cleansing of the wound, [[spoiler: Ehren]] would die anyway.
72* ''Literature/TheDarkHours'': After realizing that her punch crushed Bonner's windpipe, Renee Ballard calls her friend Garrett the EMT in a blind panic and has him guide her through an emergency tracheotomy, which is done realistically, with Renee having to use a knife to make the incision. Then, after Bonner regains consciousness and realizes that it's all over for him, he rips the plastic tube she used out of his throat, and dies.
73* In ''Literature/{{Hawk}}'', an assassin punches Vlad in the throat and collapses his windpipe, forcing him to perform this procedure ''on himself'' with the knife he'd just thrust into his attacker.
74* In ''Expendable'', of ''Literature/TheLeagueOfPeoplesVerse'', two explorers start asphyxiating in a strange atmosphere. One gets the idea of a tracheotomy in her spinning head and tries to perform it on her partner, untrained, with improvised tools, while blacking out herself. She wakes up next to the corpse and discovers that the effect is just a momentary symptom of acclimation.
75* In one ''Literature/SweetValleyHigh'' book, a man uses this procedure to save the life of another person choking at a coffee shop. By doing so, he reveals that he is a doctor, and another patron of the coffee shop recognizes him as the doctor who had recently testified against a mob boss and been forced to go into witness protection. Naturally, the guy who recognized the doctor shouts out his identity to everyone in the coffee shop so that they can all acknowledge the hero by his proper name.
76* An emergency tracheotomy performed by a non-professional is a key plot event in ''Literature/ThreeDaysToNever'' by Creator/TimPowers. It's not a neat Hollywood tracheotomy, though, and has serious repercussions.
77* In ''Literature/{{Twig}}'', Sylvester gets an amateur one from Candida after he has his throat crushed by the Baron Richmond, and is, bizarrely, able to speak in a whisper afterwards-he explains that he's regularly on the receiving end of an ImpromptuTracheotomy from any number of sources (guard dogs, knives, burrower worms...) and therefore his doctors surgically altered his throat so he could continue to try to talk his way out of it with a slit throat.
78* In ''Literature/{{Worm}}'', [[spoiler:Tattletale]] performs one [[SelfSurgery on herself]] in [[http://parahumans.wordpress.com/2013/06/06/interlude-23/ Interlude 23]] after [[spoiler:Perdition crushes her windpipe]].
79[[/folder]]
80
81[[folder:Live-Action TV]]
82* ''Series/AmericanIdol'' had some tracheotomy-related drama, though not on-stage. Season 4 contestant Anthony Fedorov had had a tracheotomy when he was a child and had been told there was a chance he wouldn't even be able to ''speak'' again. And he not only spoke, he sang. Well enough to get 4th place.
83* In an episode of ''Series/{{Beachcombers}}'', Nick had to perform a tracheotomy on someone who had collapsed due to an allergic reaction to seafood, causing his throat to swell.
84* ''Series/CallTheMidwife'': Dr. Turner has to perform an emergency tracheotomy at home for a pregnant woman who's suffocating from severe diphtheria. {{Justified|Trope}} in that this is a real treatment for extreme cases, but PlayedForDrama in that she doesn't speak English and he's still recovering his confidence after [[spoiler:misdiagnosing a baby]].
85* Seen in at least one episode of ''Series/{{Casualty}}'' when one cast member found himself in the middle of nowhere with a wrecked car whose driver hadn't been wearing a seatbelt and broken her larynx on the steering wheel or something.
86* ''Series/{{CSI}}'':
87** In an episode, one part of an incredibly convoluted RasputinianDeath involved a guy whose throat had swollen shut effectively had an emergency tracheotomy by being ''shot in the throat with a crossbow''.
88** In "Dead of the Class", the 'murder' turns out to be an emergency tracheotomy gone horribly wrong.
89* In an episode of ''Series/CSIMiami'', the coroner had to do this to some random guy on the street.
90* ''Series/DrQuinnMedicineWoman'': Dr. Mike and her daughter Colleen would perform quite a few of them.
91* Justified on ''Series/{{Emergency}}'', which, like the ''ER'' example, had a trained doctor doing one in the emergency room on a guy whose trachea had collapsed. He had to have one to keep him alive until surgery could fix it.
92* In episode 3 of ''Series/EmergencyCouple'', Chang-min and Jin Hee have to do this to a patient with esophageal cancer after they get stuck in an elevator.
93* ''Series/{{ER}}'':
94** Several dozen times at ''least''. Justified, because [[ExactlyWhatItSaysOnTheTin they take place in a fully-equipped emergency room]], on people who are in imminent danger of dying, by trained trauma specialists.
95** Subverted too. When Carol attempts a tracheotomy using a penknife, a juice straw, and duct tape on a gunshot victim in a convenience store (because she's being held hostage by a pair of robbers at the time), the patient doesn't make it.
96* Attempted in an episode of ''Series/{{Fringe}}'', due to a biological weapon that sealed bodily orifices. The skin then grew ''over the trache tube''.
97* Also somewhat justified on ''Series/GreysAnatomy'', as it's done by the certified Military Trauma Surgeon Owen Hunt, albeit done in an unconventional fashion with a ballpoint pen.
98* Seen about once every other episode on ''Series/{{House}}''.
99* Jake had to do this to a little girl in the first episode of ''Series/Jericho2006''.
100* ''Series/JudgingAmy'': Kyle does this in episode 5x05 after witnessing a bar fight.
101* Played for laughs on ''Series/{{Leverage}}'' in "The Rashomon Job." Everyone except [[spoiler: Hardison]] thinks he's having an allergic reaction and requires a tracheotomy, with the knife being handed to [[spoiler:Eliot]] getting progressively larger each time the story is retold. Subverted in that [[spoiler: Hardison]] does not actually want or need said tracheotomy, and has to con his way out of the procedure.
102* ''Series/{{Lewis}}'': In episode "[[Recap/LewisS1E2 Whom the Gods Would Destroy]]", Lewis and Anne walk into the dining room only to find Platt choking. Anne saves his life with an instant tracheotomy, without even really trying the Heimlich. It's shown realistically with Anne having to make a slice with a knife first before jamming in the pen.
103* Parodied in the ''Series/{{Lost}}'' pilot. Jack gives Rose CPR, and Boone suggests giving her a tracheotomy, and volunteers to ask passengers for pens. Jack agrees to get rid of him, then successfully revives Rose on her own. Later, Boone approaches him, hands full of pens, saying, "I wasn't sure which type works best."
104* ''Series/MalcolmInTheMiddle'' parodied this by having a grade-school student who "saw this on TV" attempt to perform a tracheotomy on someone who quite clearly did ''not'' need it. With a ''ball-point pen''.
105* ''Series/{{MASH}}'':
106** Once Father Mulcahy had to do this, with Hawkeye talking him through it via radio. For extra drama, Mulcahy is a priest, not a surgeon, they had to use an eye-dropper with the bulb snipped off for the tube, and Mulcahy was being ''shelled'' while it happened.
107** Hawkeye himself had to perform one on a North Korean soldier, after been captured to provide medical aid. In the field, without English-speaking assistants (enough yelling and gestures got the mobile soldier to hold his buddy down) or much equipment (first aid kit and a pen cap) and seemed to have been something of last resort/only thing he could try type situation. Realistically, it did not turn out well.
108** Memorably used in the episode [[Recap/MashS7E10PointOfView "Point of View"]]; which was entirely filmed from the point of view of Private Rich, a patient at the hospital. Justifies Rich saying only a few lines in the episode to avoid breaking the immersion.
109* ''Series/MondayMornings'': Young Dr. Michelle Robidaux performed one particularly difficult tracheotomy in the series finale. Her patient was practically dead and everybody gave up on him, but she managed to save him at the last moment. Her not asking for help earned her the spot of shame at the M&M meeting.
110* In an episode of ''Series/MurdochMysteries'', a hanging execution was sabotaged by shortening the rope to avoid breaking the neck and applying a tracheotomy under the condemned's clothes.
111* Parodied and subverted in ''Series/MyNameIsEarl'', where Randy has trouble breathing due to some tape being put on his mouth. Joy gets out a pen and stabs…the tape, giving him a breathing tube.
112* In an episode of ''Series/{{NCIS}}'', a former Navy medical corpsman happens upon a recent car accident and attempts a tracheotomy on one of the victims. Despite being fully trained and capable, her patient dies and she is prosecuted for practicing medicine without a license. Much drama is wrung from the fact that she'd have a civilian EMT certification, providing legal protection in such a situation, had she been discharged from the Army or Air Force instead. In the end, Gibbs pulls some strings to cut a plea deal for community service.
113* ''Series/NewAmsterdam2018'': Georgia has to do this to Max when he passes out on a dock beside a lake. Sharpe tells her what to do over the phone.
114* In ''Series/NightAndDay'', Ryan Harper has to perform one of these on Josh Alexander when a birthday cake triggers a nut allergy. As a result, Josh decides he owes Ryan his life and voluntarily becomes his slave.
115* ''Series/RFDS2021'': Season 2 has Pete, a flight nurse, forced to perform an emergency cricothyrotomy in order to insert an airway due to a string of bad luck: a passenger was ejected from the bed of an overturned ute and inhaled a bunch of mud, the locum doctor who inserted the original airway screwed up and put it too far in so it was only in one lung, and then the plane hit turbulence which caused Pete to accidentally yank the airway out completely while attempting to adjust it, and the patient's throat swelled shut. Pete succeeds at the cricothyrotomy and saves the patient, [[spoiler:but accidentally severs a nerve and renders him mute, triggering ramifications that echo for the rest of the season, ending with the board suspending his nursing license for six months after he argues with a friend of the patient]].
116* ''Series/RizzoliAndIsles'': Maura performs an emergency tracheotomy on someone who is delivered to the morgue [[WakingUpAtTheMorgue not quite dead]] in "This Is How A Heart Breaks".
117* ''Series/{{Scrubs}}'' had Turk save someone's life this way. Dr. Cox tries to provoke him by taking the credit for it.
118* ''Series/TheSilentSea''. Dr. Hong does this out of desperation after Soo-chan starts vomiting gigantic amounts of [[MurderWater lunar water]]. It does not work, as the water starts shooting out of the hole in Soo-chan's neck as well as his mouth until Soo-chan dies, having drowned from the inside.
119* ''{{Series/Wallander}}'': The episode "The Man Who Smiled" of the BBC version has Kurt Wallander performing this with a kitchen knife and a pen.
120* A variant in ''Series/WandaVision''. The Harts are visiting over for dinner when suddenly Mr. Hart chokes on his food, which prompts Vision to use his {{intangibility}} powers to reach into his throat and get the food out.
121* The first episode of ''Series/{{Wonderfalls}}'' involved this, after a character has an allergic reaction to peanuts. Since neither other person in the car actually knew how to do it properly, it led to the hilarious "We've got a stabbing victim!" line.
122* This happens in an episode of ''Series/XenaWarriorPrincess''. A [[RedShirt bounty hunter]] after Xena gets a dagger through his neck, courtesy of another bounty hunter. Xena cuts him a new breathing hole out of mercy. He still dies, though (though because of AppliedPhlebotinum, not anything Xena did)
123* ''Series/TheXFiles'': In the episode "[[Recap/TheXFilesS06E13AguaMala Agua Mala]]", Scully performs one on a police officer after he is attacked by the MonsterOfTheWeek.
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125
126[[folder:Webcomics]]
127* Parodied in a ''Webcomic/FullFrontalNerdity'' strip where the writer lists cliches he hates in movies and illustrates it by having the characters perform it on someone who has stubbed their toe.
128* An important character in ''Webcomic/TheMeek'' [[spoiler: Phe, Luca's wife]] is poisoned and a tracheotomy is used to attempt to save her life. It's not pretty. And then things go to hell.
129[[/folder]]
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131[[folder:Western Animation]]
132* Defied in ''WesternAnimation/{{Archer}}'', where he tries to drunkenly perform one on Pam with a switchblade when she's going into anaphylactic shock. Even though she's dumb enough to gorge herself on soy-based fake seafood she knows she's violently allergic to, Pam ''is'' smart enough to know an unnecessary tracheotomy will just make things worse, so she fights off Archer's UnwantedAssistance long enough to grunt out the word "Epi-Pen," which is what she actually needed.
133* In ''WesternAnimation/GIJoeRenegades'', a tracheotomy is attempted twice in one episode. Scarlett has an allergic reaction to some poison, causing her throat to swell up, and Snake-Eyes prepares to puncture her throat before Tunnel Rat manages to scrounge up some antidote. Earlier, in Snake-Eyes' backstory, [[spoiler:his Master is similarly poisoned, and Snake-Eyes tries to do the same with a sharpened bamboo shoot, but he's interrupted and simply [[MistakenForBetrayal makes the master's nephew Storm Shadow think Snake-Eyes was the murderer]].]]
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135
136[[folder:Real Life]]
137* TruthInTelevision: One of the reasons UsefulNotes/FormulaOne fans remember the 1995 Australian Grand Prix is what happened during practice: Mika Hakkinen crashed very badly, and the medics had to perform a cricothyrotomy ''on the side of the track'' just to keep him alive.
138** Also happened in 1994 at the San Marino Grand Prix to Ayrton Senna. The outcome was far less happy.
139*** Conspiracy theories suggest FIA ordered paramedics to do it so he could be artificially "kept alive" so they could resume the race. In Italy, it's illegal to finish a race where a driver is killed.
140* Drama aside, Creator/ElizabethTaylor needed a tracheotomy during a bout of pneumonia in 1960, and Creator/CatherineZetaJones needed one as a child, resulting in her distinctive scar.
141* Creator/StephenHawking got pneumonia visiting CERN in 1985, and his wife Jane even asked about cutting life support, but instead a tracheotomy was employed to save him, at the cost of his voice. After one year using "choosing letters on a spelling card with his eyebrows" to communicate, Hawking got his famous RoboSpeak machine.
142* [[http://www.ncbi.nlm.nih.gov/pubmed/20385693 This medical paper]] warns people [[DontTryThisAtHome not to attempt this at home]] with just any ball-point pen: only a few of them actually work.
143* One story from the ''Website/DarwinAwards'' features a man who, in a bout of AlcoholInducedStupidity, stuck a rattlesnake into his mouth, with the obvious outcome. His tongue was so badly swollen that doctors had to perform a tracheotomy. (He survived.)
144[[/folder]]

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