Abstract: The embodiments pertain to tracheostomy tubes with an outer cannula and a disposable inner cannula which is connected to a ventilator coupling and the other end of the ventilator coupling connected to the ventilator tubing. The existing connection between the disposable inner cannula and the ventilator coupling is made by simple insertion of the disposable inner cannula into the ventilator coupling and unintentional disconnections do occur. Embodiments consist of locking or securely fastening the connection between the disposable inner cannula and the ventilator coupling. One embodiment consists of level arms that are mounted on a ventilator coupling and a retaining collar mounted on a disposable inner cannula to securely fasten the ventilator coupling to the disposable inner cannula. This will prevent accidental or unintentional disconnection and thereby the patient's health will not be compromised nor will it deteriorate and death may be prevented.