Best Case Ever 36 Tracheo-innominate Fistula

In this Best Case Ever with Dr. Scott Weingart, the brains behind, 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.emergency management of pediatric seizures

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.

Recorded May 2015; Published June 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


McGrath BA et al. Multidisciplinary guidelines for the management of tracheostomy and laryngectomy airway emergencies. Anaesthesia. 2012;67:1025-41.

Dr. Helman & Dr. Weingart have no conflicts of interest to declare

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About the Author:

Dr. Anton Helman is an Emergency Physician at North York General in Toronto. He is an Assistant Professor at the University of Toronto, Division of Emergency Medicine and the Education Innovation Lead at the Schwartz-Reisman Emergency Medicine Instititute. He is the founder, editor-in-chief and host of Emergency Medicine Cases.

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