When ventilating a patient with a stoma and air escapes from the mouth and nose, what should you do?

• A. Seal mouth and nose
• B. Thrust the jaw forward
• C. Suction the stoma
• D. Ventilate with less pressure

Answer: (A)

Sealing the mouth and nose is the right move because when the airway is through the stoma, air should go directly into the trachea. If air escapes out of the mouth or nose, the delivered breathes aren’t reaching the lungs and tidal volume is lost. By occluding the upper airway (the mouth and nose), you create a closed circuit so the ventilations you deliver go through the stoma. This improves chest rise and oxygen delivery with each breath.

The other actions don’t fix the immediate issue: bending the jaw forward helps open the upper airway for non-stoma ventilation but doesn’t stop the leak at the mouth and nose; suctioning the stoma targets secretions blocking the stoma itself rather than preventing air from escaping through the mouth and nose; venting with less pressure reduces leakage but compromises ventilation efficiency, which isn’t the best fix when you need adequate breaths via the stoma.