An instrument for providing ventilation access to the trachea has a hollow needle with a sharp tip, a tube extending within the needle and a spring urging the tube to project a short distance from the patient end of the needle. The rear end of the tube carries two colored flags one of which is visible at a time in a transparent window towards the machine end of the needle. When the patient end of the instrument is pushed through neck tissue overlying the trachea the inner tube is pushed rearwardly so that a flag of one color is visible. When the patient end of the instrument enters the trachea the spring can push the inner tube forwardly so that the other flag is visible. In one embodiment the instrument carries a dilator and tracheostomy tube that can be slid off the needle after penetration. In another embodiment, ventilation equipment is connected to the rear of the inner tube and the patient is ventilated through the instrument itself.