A tracheotomy tube apparatus includes an outer cannula having first and second ends, and a fenestration along the length of the outer cannula between the first and second ends. The apparatus further includes a first inner cannula sized for insertion into the outer cannula. The first inner cannula has a raised region substantially to close the fenestration when the first inner cannula is inserted into the outer cannula. The apparatus further comprises a second inner cannula for insertion into the outer cannula when the first inner cannula is removed therefrom. The second inner cannula includes a resilient region which lies adjacent the fenestration when the second inner cannula is properly oriented within the outer cannula, a valve at an end thereof and a region between the resilient region and the end thereof which provides a passageway between the second inner cannula and the outer cannula when the second inner cannula is properly oriented within the outer cannula. A first coupler is provided on an outer end of the outer cannula. Second couplers are provided on outer ends of the first and second inner cannulae. The first and second couplers are provided with means for guiding the first and second inner cannulae into the predetermined orientations with respect to the outer cannula. The outer cannula further comprises an inflatable cuff formed by a sleeve including a first end, a second end, and a third region between the first and second ends. The sleeve is located around the outer cannula with at least one of the first and second ends of the sleeve between the outer cannula and the third region of the sleeve. The outer cannula further comprises a conduit extending from a first end of the outer cannula to the cuff for introducing an inflating fluid into the cuff when it is desired to inflate the cuff and removing inflating fluid from the cuff when it is desired to deflate the cuff. The first inner cannula includes a second conduit to evacuate a region of a trachea o