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.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.

Podcast: Play in new window | Download (Duration: 14:12 — 13.0MB)

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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

Reference

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