5 Key points: • As an aerosol-generating procedure (AGP), tracheostomy poses significant viral transmissions risks to health care workers • The decision about tracheostomy method and optimal setting depends on a multitude of local factors with no available studies to suggest the superior option • We describe our effective, safe and swift approach to bedside open tracheostomy during the COVID-19 pandemic • A key approach in performing an effective bedside tracheostomy is to ensure that the procedure is standardised and performed by highly experienced surgeons, anaesthetist and scrub team. • Our experience with bedside open tracheostomy demonstrated a short mean procedural time, with no tracheostomy-related complications and no reported viral transmission amongst the healthcare members involved.