65 year old man with a 120 pack year smoking history who has been in the surgical intensive care unit (SICU) for 24 hours. He had a total laryngectomy performed 1 day prior for laryngeal carcinoma. He required mechanical ventilatory support immediately postoperatively via a #8 cuffed tracheostomy tube with an inner cannula. You are called to the bedside by the intensive care unit nurse because immediately after completion of a portable chest x-ray the ventilator low pressure alarm is going off and the nurse notes that the new tracheostomy has been totally displaced from the stoma and is sitting on the chest wall, and the patient is hypoxic, tachypneic and in respiratory distress.
Emergency medicine, ENT, Internal medicine, Pulmonology, Surgery
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