You are called into a patient's room by the nurse because blood is spurting from the tracheosto-my site, which was placed 2 weeks ago. The patient is receiving mechanical ventilatory support and has a history of liver failure and CHF

Which of the following conditions is the most likely cause?
a. Acute pulmonary edema
b. Rupture of the innominate artery
c. Pulmonary hemorrhage
d. Pneumothorax

ANS: B
Rupture of the innominate artery is a potentially serious airway complication and the mortality rate for this condition is high. It usually is seen in the first 3 weeks after a tracheostomy. The immediate indication is blood spurting from the tracheotomy site.