Clinical scenario: 72 yo F with history of lung carcinoma with permanent trachestomy placed four months prior presentation, brought by EMS with profuse, active bleeding from the stoma site. Patient is ventilator dependent and is being assisted with BVM at arrival. Per nursing home staff bleeding was noted an hour prior presentation and there was no history of unusual manipulation or trauma. Previous management had included aspiration and local pressure with dressings. Patient’s O2 Saturation is 97% at arrival on 40% FIO2. BP is 102/60 and HR 100. Mental status is normal.
What the next step in management of this patient?