65 year old man who has been in the medical intensive care unit for 30 days for ARDS following pneumococcal pneumonia related septic shock. He had a percutaneous tracheostomy performed 20 days ago and he continues to require mechanical ventilatory support. Learner is called to the bedside by the intensive care unit nurse because the nurse has reported that bright red blood is oozing out of the tracheostomy and around the stoma. Learner should suspect trachea-innominate fistula (TIF), call for an airway team and stat ENT consult, and perform the appropriate bedside management for TIF.
Emergency medicine, ENT, Internal medicine, Pulmonology, Surgery
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