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Instant Drama, Just Add Tracheotomy
There seems to be a trend in Hollywood. If a scene is falling flat, add someone choking. But the Heimlich maneuver is boring and over played (and honestly just looks ridiculous). Wait, I know! He's not really choking, he's suffocating! And that means, instead of the boring, vaguely erotic reach-around of the Heimlich, our heroes get to slice someone open.

Sometimes 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 Hollywood medical techniques, this often goes smoothly and without complications...even when performed by non-doctors.

Supposedly, 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.

It's worth noting that in most cases, what the characters perform is not actually a tracheotomy but a cricothyrotomy.

Not to be confused with an Impromptu Tracheotomy.

Examples

Comic Books
  • In an issue of Deadpool (or possibly Agent X), Death Trap creator Arcade does this, much to everyone's surprise — not just that he knew how, but that he'd bother.
  • 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.
    • In a Detective Comics story arc during the '90s, The Riddler 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.
  • 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.
  • In Knights of the Old Republic Slyssk needs to have one after being force chocked. It's mentioned that since he's a Trandoshan, his natural toughness and regenerative abilities will keep him alive when it would most likely still be fatal for other species.

Film
  • Jared Leto's character perform ones in Switchback to establish his character used to be in med school.
  • David performed one in Just Like Heaven despite having no medical training. Elizabeth's quasi-ghost talks him through it.
  • In Nurse Betty, Betty successfully performs a tracheotomy, knowing how to do so from obsessively watching a medical soap opera.
  • In 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 improptu tracheotomy. 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.
  • Saw V 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.
  • In Nancy Drew, Nancy performs this on a classmate who has a severe allergic reaction at a party (much to the horror of the other guests). The movie plays with the idea that Nancy is always Crazy-Prepared for emergencies and appears to have had some degree of medical training.
  • In The Princess And The Warrior, this is how the protagonists meet— Bodo, after inadvertently causing Sissi to be hit by a truck, performs an emergency tracheotomy note  on her and disappears before Sissi can learn his name. As a result, she becomes obsessed with tracking him down.
  • In The Sweet Hereafter, 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. 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.
  • In Darkness, Anna Paquin is instructed to do this in order to save her father's life. Subverted because this is done in attempt to make her unknowingly kill her father.
  • "Idiots trying this when they don't know what they're doing" is used for a fantastic subversion of Chekhov's Skill in The Heat. 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.
  • One character in The Legacy starts suddenly choking from a chicken bone during dinner. Heimlich maneuver doesn't do anything, and the nurse of the house's owner proceed to try to save his live with tracheotomy.

Literature
  • An emergency tracheotomy performed by a non-professional is a key plot event in Three Days to Never by Tim Powers. It's not a neat Hollywood tracheotomy, though, and has serious repercussions.
  • In Expendable, of The League of Peoples Verse, 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.
  • This trope is Lampshaded in Choke by Chuck Palahniuk. 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.
  • In Codex Alera, this is performed on 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, Ehren would die anyway.
  • In 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.

Live-Action TV
  • In episode 3 of Emergency Couple, Chang-min and Jin Hee have to do this to a patient with esophageal cancer after they get stuck in an elevator.
  • Seen about once every other episode on House.
  • Scrubs had Turk save someone's life this way. Dr. Cox tries to provoke him by taking the credit for it.
  • In an episode of Beachcombers, Nick had to perform a tracheotomy on someone who had collapsed due to an allergic reaction to seafood, causing his throat to swell.
  • This happens in an episode of Xena: Warrior Princess. A 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 Applied Phlebotinum, not anything Xena did)
  • The first episode of 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.
  • Mash:
    • 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 a pen cap or an eye-dropper with the bulb snipped off for the tube, and Mulcahy was being shelled while it happened.
    • Hawkeye himself had to perform one. It was in the field without assistants or much equipment and seemed to have been something of last resort/only thing he could try type situation. Realistically, it did not turn out well.
  • Attempted in an episode of Fringe, due to a biological weapon that sealed bodily orifices. The skin then grew over the trache tube.
  • In an episode of CSI: Miami, the coroner had to do this to some random guy on the street.
  • CSI:
    • In an episode, one part of an incredibly convoluted Rasputinian Death involved a guy whose throat had swollen shut effectively had an emergency tracheotomy by being shot in the throat with a crossbow.
    • In "Dead of the Class", the 'murder' turns out to be an emergency tracheotomy gone horribly wrong.
  • American Idol 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.
  • Malcolm in the Middle parodied this by having a grade-school student who "saw this on TV" attempt to preform a tracheotomy on someone who quite clearly did not need it. With a ball-point pen.
  • Jake had to do this to a little girl in the first episode of Jericho.
  • Seen in at least one episode of 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.
  • Parodied in the 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."
  • Judging Amy: Kyle does this in episode 5x05 after witnessing a bar fight.
  • ER:
    • Several dozen times at least. Justified, because they take place in a fully-equipped emergency room, on people who are in imminent danger of dying, by trained trauma specialists.
    • 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.
  • Played for laughs on Leverage in "The Rashomon Job." Everyone except Hardison thinks he's having an allergic reaction and requires a tracheotomy, with the knife being handed to Eliot getting progressively larger each time the story is retold. Subverted in that Hardison does not actually want or need said tracheotomy, and has to con his way out of the procedure.
  • In an episode of Murdoch Mysteries, a hanging execution was sabotaged by shortening the rope to avoid breaking the neck and applying a tracheotomy under the condemned's clothes.
  • Rizzoli & Isles: Maura performs an emergency tracheotomy on someone who is delivered to the morgue not quite dead in "This Is How A Heart Breaks".
  • Dr. Quinn, Medicine Woman: Dr. Mike and her daughter Colleen would perform quite a few of them.
  • Monday Mornings: Young Dr. Michelle Robidaux performed one particularly difficult tracheotomy in the series finale. Her patient was practically dead and everybody gave up on hhim, 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.
  • Justified on 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.
  • Wallander: The episode "The Man Who Smiled" of the BBC version has Kurt Wallander performing this with a kitchen knife and a pen.

Webcomics
  • Parodied in a Full Frontal Nerdity 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.
  • An important character in The Meek 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.

Web Original

Western Animation
  • In G.I. Joe: Renegades, this is mentioned but eventually averted twice in one episode. Scarlett has an allergic reaction to some poison, causing her throat to swell up, and Snake-Eyes is about to do this before Tunnel Rat manages to scrounge up some antidote. Earlier, in Snake-Eyes' backstory, his Master is similarly poisoned, and Snake-Eyes is about to do this, but is interrupted before he can help.

Real Life
  • Truth in Television: One of the reasons Formula One fans remember the 1995 Australian Grand Prix is what happened during practice: Mika Hakkinen crashed very badly, and the medics had to perform a tracheotomy on the side of the track just to keep him alive.
    • Also happened in 1994 at the San Marino Grand Prix to Ayrton Senna. The outcome was far less happy.
      • Conspiracy theories suggest FIA ordered paramedics to do it so he could be artifically "kept alive" so they could resume the race. In Italy, it's illegal to finish a race where a driver is killed.
  • Drama aside, Elizabeth Taylor needed a tracheotomy during a bout of pneumonia in 1960, and Catherine Zeta-Jones needed one as a child, resulting in her distinctive scar.
  • This medical paper warns people not to attempt this at home with just any ball-point pen: Only few of them actually work.


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