You are ventilating a patient with a stoma; however, air is escaping from the mouth and nose. To prevent this, you should:

• A. seal the mouth and nose.
• B. ventilate with less pressure.
• C. thrust the jaw forward.
• D. thoroughly suction the stoma.

Answer: (A)

When ventilating through a stoma, air can escape through the mouth and nose, defeating the delivery of breaths into the trachea. Sealing the mouth and nose creates a closed path so the entire ventilatory effort goes into the stoma and into the lungs, increasing effective tidal volume. The other options don’t fix the leak path: reducing ventilation pressure doesn’t stop the air from escaping via the upper airway; moving the jaw forward helps open the airway but doesn’t address air escaping through the mouth and nose; suctioning the stoma clears secretions but doesn’t stop air from leaking out of the mouth or nose.