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 Consent for procedure includes the risks of: pneumothorax (PTX), tracheo‐innominate artery fistula, airway damage and stenosis, bleeding, infection, and death.

 Mortality of this procedure is less than 1%, while major morbidity is 5–10%.

 Bleeding with PDT is minimal. Prior ultrasonography of the trachea assesses for any smaller crossover veins, which are uncommon but may cause bleeding.

 PTX is a serious complication that can be fatal if not immediately recognized and treated. It presents with difficulty in ventilation, hypotension, and/or oxygen desaturation due to tension PTX, and often within minutes of the tracheotomy. Chest tube kits should be readily available during these procedures.

 Innominate artery fistula can either be a relatively early or late event, and is a surgical emergency. A surgeon should immediately assess any bleeding from the tracheostomy site since any manipulation of the tube may undo the (possibly life‐saving) tamponade effect on the fistula.

 Tracheal stenosis and tracheomalacia can be late complications at the tracheostomy site.