If air escapes through the mouth when ventilating through a stoma, what step should you take?

• A. Seal the mouth and nose
• B. Increase the ventilation pressure
• C. Suction the stoma
• D. Tilt the head back

Answer: (A)

When ventilating through a stoma, the goal is to push air directly into the airway via the stoma. If air is escaping through the mouth, it means some of the breath is taking the path of least resistance in the upper airway. The correct action is to seal the mouth and nose to create an airtight seal, directing all the delivered breaths through the stoma and into the lungs.

Sealing the mouth and nose effectively increases the likelihood that the chest rises with each ventilation and that the air reaches the lower airway. Increasing ventilation pressure or tilting the head back doesn’t address the leak path and can risk other complications. Suctioning the stoma is only appropriate if there’s a clear obstruction, not to fix a leak through the upper airway.