(http://emergencymedicinecases.com/wp-content/uploads/2015/05/trach-bleeding.png)In this Best Case Ever with Dr. Scott Weingart, the brains behind EMcrit.org, we hear the devastating story of a tracheostomy gone bad. Dr. Weingart shares with us what he has learned about how to manage massive hemoptysis in tracheostomy patients, and in particular, a step-wise approach to managing a tracheo-innominate fistula. We discuss the balance between providing maximal aggressive critical care while maintaining a deep respect for the risks associated with the procedures we perform. Recorded at North York General's EM Update Conference, 2015.

 

To review the initial management of massive hemoptysis in the tracheostomy patient and how to deal with the dreaded tracheo-innominate fistula see Justin Morgenstern's First10EM post - The Bleeding Tracheostomy

 
Repair of a Tracheo-innominate Fistula
https://youtu.be/2LBN8ou4z00