Stoma Emergencies

Question 1

Default route of oxygenation/ventilation in all stoma patients

Answer 1

Via stoma - works for both lary/trach patients.

Can do via both if 2 oxygen sources available.

Question 2

Technique for suction obstructed stoma

Answer 2

Remove inner cannula if present, Insert >10cm, slowly withdraw while suctioning for a max of 10s

Question 3

If unable to pass a suction catheter through the stoma

Answer 3

Likely completely occluded, deflate the cuff and suction (secretions from around cough will be released)

Question 4

Suction catheter size for stoma suction

Answer 4

10-12 FG Y catheter for adults, or less than half diameter for paeds.

Question 5

If apnoeic/arrest

Answer 5

Remove outer tube of stoma, ventilate via stoma with neonatal facemask.

If significant leaks via upper airway, occlude stoma and ventilate via mouth.