{"version":1,"type":"rich","provider_name":"Libsyn","provider_url":"https:\/\/www.libsyn.com","height":90,"width":600,"title":"Podcast 788: Tracheostomy Bleeding","description":"Contributor: Aaron Lessen, MD Educational Pearls:  Tracheostomy bleeding is a rare but potentially life-threatening complication that usually occurs within the first month of tracheostomy tube placement No matter how severe the bleeding, every patient should be evaluated to rule out a tracheo-innominate fistula between the tracheostomy and the innominate artery If the patient is currently bleeding and has a cuffed tracheostomy tube, over-inflate the balloon to compress the bleeding vessel Consider replacing an uncuffed tracheostomy tube with a cuffed tube or an ET tube  If the tracheostomy was performed in the last seven days, use a bougie or bronchoscope to replace the uncuffed tube due to increased risk of opening a false track into the subcutaneous tissue  If bleeding cannot be controlled, follow mass-transfusion protocols, and as a last resort, remove the tube and insert a finger into the stoma to manually compress the artery  References Bontempo LJ, Manning SL. Tracheostomy Emergencies. Emerg Med Clin North Am. 2019;37(1):109-119. Khanafer A, Hellstern V, Mei\u00dfner H, et al. Tracheoinnominate fistula: acute bleeding and hypovolemic shock due to a trachea-innominate artery fistula after long-term tracheostomy, treated with a stent-graft. CVIR Endovasc. 2021;4(1):30. Manning Sara, Bontempo Laura. Complications of Tracheostomies. In: Mattu A and Swadron S, ed. ComPendium. Burbank, CA: CorePendium, LLC. https:\/\/www.emrap.org\/corependium\/chapter\/reckOdDn9Ljn7sBLy\/Complications-of-Tracheostomies. Updated August 17, 2021. Accessed June 5, 2022. &amp;nbsp; Summarized by Mark O\u2019Brien, MS4 | Edited by John Spartz, MD, MPH &amp; Erik Verzemnieks, MD &amp;nbsp; The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits\u2122 via online course modules. To access these and for more information, visit our website at https:\/\/emergencymedicalminute.org\/cme-courses\/ and create an account.&amp;nbsp;  Donate to EMM today!   ","author_name":"Emergency Medical Minute","author_url":"https:\/\/www.emergencymedicalminute.com","html":"<iframe title=\"Libsyn Player\" style=\"border: none\" src=\"\/\/html5-player.libsyn.com\/embed\/episode\/id\/23348906\/height\/90\/theme\/custom\/thumbnail\/yes\/direction\/forward\/render-playlist\/no\/custom-color\/fa102a\/\" height=\"90\" width=\"600\" scrolling=\"no\"  allowfullscreen webkitallowfullscreen mozallowfullscreen oallowfullscreen msallowfullscreen><\/iframe>","thumbnail_url":"https:\/\/assets.libsyn.com\/secure\/content\/129375608"}