A 22-year-old woman recovering from a traumatic head injury is noted to have bright red bleeding when her tracheostomy is suctioned. The following is/are true statement(s):

b. Deflation of the tracheal tube cuff is a useful diagnostic maneuver

c. If massive bleeding occurs, a finger should be used to compress the innominate artery against the sternum

The complication of tracheoinnominate artery fistula characteristically occurs in young women and is often heralded by bleeding during the tracheostomy suctioning. Deflation of the tracheal tube cuff confirms the diagnosis if massive bleeding occurs. At that point the tracheal tube cuff should be overinflated and a finger inserted into the tracheostomy incision to tamponade the bleeding. Throughout this, the airway must be protected. Operative repair through an upper sternal split requires resection of the innominate and coverage of the oversewn vessels with viable tissue since the wound is contaminated. No prosthetic material should be inserted and tracheal resection is not necessary.