Key points: • When deflated, folds often form in the balloon cuff of a tracheostomy tube resulting in additional friction when inserting the tube. • Furthermore, this potentially increases the risk of cuff rupture, particularly in patients with calcified tracheas and iatrogenic tracheal injury from using excessive physical force when inserting a tracheostomy tube. • The ‘Umbrella Furling’ technique for deflating the cuff of a tracheostomy tube is a simple approach whereby the cuff is slowly deflated with a damp gauze wrapped around it while simultaneously twisting the tracheostomy tube. • This enables the deflated cuff to sit flush to the tube, therefore allowing an easier “reduced-friction” insertion of a cuffed tracheostomy tube and reducing the risk of damage to the cuff. • The same technique can be used to facilitate the insertion of endotracheal tubes through an enclosed laryngoscope.