Above website great resource and has 2 videos of procedure.
With advent of velcro trach ties, change little easier as can more quickly secure tube in place. First video shows trach insertion without any trach ties attached. I find it easier if using velcro tie to have it attached to one side of trach flange as shown in video #2, can quickly place behind neck and attach second side preventing patient from moving head or coughing out tube.
ALWAYS insert obturator into cannula to aide in inserting and preventing scrapes to airway, immediately remove then focus on securing ties. Occasionally inserting airway with flange at 12 & 6 o'clock position then rotating 45 degrees to 3 & 9 o'clock position will get past any fibrous trach tissue....along with using dab of surgical lubricant.
Insert inner cannula, inflate cuff if needed, reattach to oxygen source if used and complete! Can be done in less than 1 minute if no bucking broncho.....just have everything opened and preped prior to start of procedure.
Rarely need to have neck hyperexteneded in bedbound patient.
Good Luck mastering this skill!
PM if needed as respiratory my specialty.