WORLD EMERGENCY MEDICINE SOCIETIES & RELATED

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Tuesday, January 19, 2021

Tracheoinnominate Artery Fistula

EM SIM CASES
EM SIM CASES - January 19, 2021 - By Jared Baylis
..."Tracheostomy patients are infrequently seen in the emergency department, leading to an unfamiliarity around important anatomical considerations and tracheostomy hardware management. These individuals can harbour acutely life-threatening pathology, with the most feared being the tracheoinnominate artery fistula. This diagnosis requires a high level of suspicion and a sequence of rapid interventions to protect the airway from on-going hemorrhage, temporize the bleeding via a HALO procedure (Utley maneuver), and stabilize the patient for definitive OR management. The team leader’s crisis resource management skills will be strained in this case given the multitude of serious competing life-threats, navigation of unfamiliar and complex airway anatomy, and the utilization of a HALO procedure..."