The present disclosure provides for a method of performing a percutaneous dilational tracheostomy (“PDT”) that includes inserting a tracheal tube including an inflatable cuff through a mouth and into a trachea of a patient； inserting a bronchoscope into the tracheal tube； inserting a puncturing wire through a channel of the bronchoscope. The puncturing wire includes a sharp cutting end and a dull gripping end. The method also includes puncturing the trachea of the patient with the sharp cutting end of the puncturing wire from within the trachea at a selected location to create a stoma； passing at least one dilator over the sharp cutting end of the puncturing wire for dilating the stoma； inserting a tracheostomy tube into the trachea through the stoma； and removing the puncturing wire from the patient.
