Local<unk> 
Use silver nitrate if<unk>  source is identified
Brisk<unk> 
Tracheoinnominate artery fistula (TIF) until proven otherwise
Most patients present within first 3wk after tracheostomy
May be preceded by hours to days with small-volume "sentinel bleed"
Very high mortality rate
Delegate team member to obtain surgical assistance, especially with massive bleed
Treatment:
Hyperinflate the cuff (85% successful), up to 50 cc to tamponade<unk> 
If above fails, withdraw tube while placing pressure against anterior trachea
ETT from above (as long as there is no laryngectomy)
Apply digital pressure of innominate artery against the manubrium from inside tracheostomy tract
Go to the OR with finger tamponade innominate artery
If above fails, place a cuffed ET tube to prevent pulmonary aspiration of blood
Correct coagulopathies and administer blood products as needed
Requires emergent OR exploration and definitive management
Use silver nitrate if<unk>  source is identified
Tracheoinnominate artery fistula (TIF) until proven otherwise
Most patients present within first 3wk after tracheostomy
May be preceded by hours to days with small-volume "sentinel bleed"
Very high mortality rate
Delegate team member to obtain surgical assistance, especially with massive bleed
Treatment:
Hyperinflate the cuff (85% successful), up to 50 cc to tamponade<unk> 
If above fails, withdraw tube while placing pressure against anterior trachea
ETT from above (as long as there is no laryngectomy)
Apply digital pressure of innominate artery against the manubrium from inside tracheostomy tract
Go to the OR with finger tamponade innominate artery
If above fails, place a cuffed ET tube to prevent pulmonary aspiration of blood
Correct coagulopathies and administer blood products as needed
Requires emergent OR exploration and definitive management
Most patients present within first 3wk after tracheostomy
May be preceded by hours to days with small-volume "sentinel bleed"
Very high mortality rate
Delegate team member to obtain surgical assistance, especially with massive bleed
Treatment:
Hyperinflate the cuff (85% successful), up to 50 cc to tamponade<unk> 
If above fails, withdraw tube while placing pressure against anterior trachea
ETT from above (as long as there is no laryngectomy)
Apply digital pressure of innominate artery against the manubrium from inside tracheostomy tract
Go to the OR with finger tamponade innominate artery
If above fails, place a cuffed ET tube to prevent pulmonary aspiration of blood
Correct coagulopathies and administer blood products as needed
Requires emergent OR exploration and definitive management
ETT from above (as long as there is no laryngectomy)
Apply digital pressure of innominate artery against the manubrium from inside tracheostomy tract
Go to the OR with finger tamponade innominate artery
Tracheostomy bleeding
Tracheostomy obstruction
Tracheostomy dislodgement
Tracheostomy complications
Tracheostomy infection
The difficult airway
Hemoptysis
Chylous leak