Managing the bleeding tracheostomy

[@javiercasasr]

Thanks for sharing this video!! I have had the opportunity to attend a similar event, it happened a long time ago when I was an Emergency resident, unfortunately, the patient died! Despite not being frequent, it is always good to know what to do, I have always remembered this event.

[@kamranashraf7308]

excellent . please keep making videos regarding ICU care, ventilator settings in managing traumatic brain injuries ,septic shock etc

[@Duppuccino]

So glad to find this channel. Keep up the great work!!

[@First10EM]

Thank you!

[@ningayeti]

What are your thoughts on utilizing the following in your scenario 1. Trendelenburg to prevent blood flow down the trachea (if pt tolerates) 2. Immediate correction of any hypertension or even permissive hypotension to maximise the effectiveness of direct pressure maneuvers. Thanks

[@First10EM]

Trendelenburg and permissive hypotension (or lowest possible normotension) make some sense. I wouldn't give anything to lower the BP. The problem with trendelenburg initially is that the patient is unlikely to tolerate it, as lying flat isn't really compatible with respiratory distress. As long as possible, I would have them sitting forward and managing their own secretions.

[@HarryNonez]

For bleeding- how can you tell pt has cuffed or uncuffed tube from the beginning? When intubating from above, im assuming i would have to deflate the trach cuff in order to push the tube through past it correct?

[@First10EM]

The cuffed tube will have a port hanging off it to inflate/ deflate the cuff. If you are intubating from above, you will remove the trach.

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