title: Resuscitating the tracheostomy patient in the ED.
abstract: BACKGROUND
  Emergency physicians must be masters of the airway. The patient with tracheostomy can present with complications, and because of anatomy, airway and resuscitation measures can present several unique challenges. Understanding tracheostomy basics, features, and complications will assist in the emergency medicine management of these patients.
  
  
  OBJECTIVE
  The aim of this review is to provide an overview of the basics and features of the tracheostomy, along with an approach to managing tracheostomy complications.
  
  
  CONCLUSIONS
  This review provides background on the reasons for tracheostomy placement, basics of tracheostomy, and tracheostomy tube features. Emergency physicians will be faced with complications from these airway devices, including tracheostomy obstruction, decannulation or tube dislodgement, stenosis, tracheoinnominate fistula, and tracheoesophageal fistula. Critical patients should be evaluated in the resuscitation bay, and consultation with ENT should be completed while the patient is in the department. This review provides several algorithms for management of complications. Understanding these complications and an approach to airway management during cardiac arrest resuscitation is essential to optimizing patient care.
  
  
  CONCLUSIONS
  Tracheostomy patients can present unique challenges for emergency physicians. Knowledge of the basics and features of tracheostomy tubes can assist physicians in managing life-threatening complications including tube obstruction, decannulation, bleeding, stenosis, and fistula.
authors.affiliation: Department of Emergency Medicine, San Antonio Military Medical Center, Houston, TX 78234. Electronic address: brit.long@yahoo.com.
authors.forename: Brit
authors.initials: B
authors.lastname: Long
authors.affiliation: Department of Emergency Medicine, The University of Texas Southwestern Medical Center, Dallas, TX 75390. Electronic address: akoyfman8@gmail.com.
authors.forename: Alex
authors.initials: A
authors.lastname: Koyfman
mesh_terms: D058109:Airway Management; D004636:Emergency Service, Hospital; D006801:Humans; D012151:Resuscitation; D014139:Tracheostomy