The nurse is teaching a group of staff nurses about complications associated with a tracheostomy. Which of the following conditions would the nurse include? Select all that apply

A. Tracheostomy placement can injure the recurrent laryngeal nerve, leading to hoarseness, vocal cord paralysis, or difficulty speaking. This is a recognized complication, especially with high tracheal incisions or improper surgical technique. B. Coronary artery occlusion is a cardiac event unrelated to tracheostomy. Tracheostomy procedures do not directly affect the coronary arteries. C. Air can escape from the trachea into surrounding tissue if there is improper tube placement, cuff leak, or airway trauma, causing subcutaneous emphysema. This is a known complication and requires monitoring. D. Accidental puncture of the pleura during tracheostomy insertion can lead to pneumothorax, especially in patients with underlying lung disease or difficult anatomy. Immediate recognition and intervention are critical. E. Gastric bleeding is not a direct complication of a tracheostomy. While critically ill patients may be at risk for stress-related mucosal damage, this is not caused by the tracheostomy itself.