What should be done in case there is no chest rise during ventilation via a stoma or tracheostomy tube?

In a situation where there is no chest rise during ventilation through a stoma or tracheostomy tube, the appropriate action is to check to ensure the airway is clear and possibly connect the bag directly to the tracheostomy tube. This approach is crucial because it addresses the immediate concern of ensuring adequate ventilation.

When there is no chest rise, it indicates that air is not effectively entering the lungs. The first step should always be to confirm that the airway is not obstructed. In cases of a tracheostomy, it’s essential to ensure that secretions or any other obstruction are not impeding airflow. By potentially connecting the bag directly to the tracheostomy tube, you eliminate any complications that may arise from trying to ventilate through a mask that may not be sealing properly or is not the right size for the stoma.

This action is aligned with best practices in emergency airway management, where the goal is to restore airway patency and ensure effective ventilation as swiftly as possible, especially when traditional methods may not suffice. Taking these steps helps to quickly reassess the situation and provide the necessary ventilation support.