Stoma: Although Rare, First Aiders Encounter Someone With One
A stoma is the Greek word for mouth, but more commonly it refers to a surgically created opening. The medical term for this is Laryngectomy, and it is the removal of the larynx (partial or total) and the separation of the airway from the esophagus, and the mouth and nose.
In the context of first aid, a stoma is cut into a person's throat in a situation where someone can't otherwise breath. This hole will be located just below the Adam's apple, or the epiglottis, and it is connected directly to the person's lungs.
A stoma can also be created surgically, with the most common reason being throat cancer, usually of the larynx, but it can also be a necessity due to a physical injury.
Note: This is a serious surgical procedure and should never be attempted as a first aid procedure by a layperson. It is much too dangerous, despite what we might see on television.
If you ever encounter a first aid situation where someone has a stoma, and you need to perform rescue breathing, it is through this hole that you would need to blow. It may sound odd, but not only does it work, it works more efficiently than breathing into their mouth.
Some of the ways you would know if someone has a stoma or a neck breather are:
- You try to blow into their mouth and you see their stomach rising as opposed to their chest.
- They may have a medical alert bracelet/necklace that states this.
- You may see the actual hole or surgical scars in the throat area.
- They may be covering the hole with a scarf, perhaps from embarrassment. Don't be afraid to move it out of the way to see if they are neck breathers.
In terms of giving them breaths, there is one major advantage over breathing into someone's mouth; the air can't get into the person's stomach and cause gastric distention. The reason for this is because the opening is attached only to the wind pipe (trachea) and only goes to the lungs. There is also a lower chance of the person vomiting and if they do there will be no interference with their airway because the vomit will come out of their mouth rather than through the stoma.
The stoma may be held open by a plastic ring. Do not remove this ring. If you do the opening may collapse and it will be harder for the person to breathe or for you to administer rescue breaths.
Remember, the term stoma simply means a surgical opening. Therefore there can be other types, such as, stomas that have to do with the digestive system. Someone with cancer that had to have a section of their digestive system (intestines) removed may have an abdominal stoma. This stoma is designed to collect the stool as it is excreted from the intestines. These types of stomas are referred to as; colostomy, ileostomy, and urostomy (used to collect urine).