A tracheostomy dilator may include a distal portion, a handle portion, a lumen, and a proximal portion. The distal portion may have a curve extending to a distal opening and be configured to dilate a tracheostomy. The handle portion may be proximal of the distal portion and be configured to be grasped by a user. The lumen may be configured to receive a guidewire. The proximal portion may be proximal of the handle portion and have a proximal opening in communication with the lumen. The proximal portion may be configured to deflect the guidewire at an angle of at least 30 degrees from a longitudinal axis of the handle portion.