Inclusion Criteria:  Non-pregnant patients over 18 years of age Patients who need a tracheostomy Patients whose opening method of tracheostomy is suitable for percutaneous tracheostomy.  Exclusion Criteria:  Refusal of the procedure by the patient or her legal representative Patients under the age of 18 Body mass index> 35 patient group Patients with a mass in the neck region for any reason Skin infection at the procedure site Coagulopathy Inability to palpate the cricoid cartilage