Emergency Medical Technician (EMT) Intermediate Practice Exam

When ventilating a patient with a stoma and a tracheostomy tube, you should:

1. Attach the bag-mask device to the 15-mm adaptor on the tube

2. Ventilate without any adjuncts

3. Use a standard bag-mask device without modification

4. Insert an oropharyngeal airway before ventilating

The correct answer is: Attach the bag-mask device to the 15-mm adaptor on the tube

Using a bag-mask device with a 15-mm adaptor on a tracheostomy tube is the correct approach when ventilating a patient with a stoma and tracheostomy tube. This method ensures an effective seal and proper ventilation since the 15-mm adaptor is specifically designed to fit the connector of the tracheostomy tube. By attaching the bag-device directly to the tracheostomy, the EMT can deliver positive pressure ventilation more efficiently, making it easier to manage the patient's airway and ensure adequate oxygenation and ventilation. Ventilating without any adjuncts would be inappropriate as it may not provide an adequate seal, which is crucial for effective ventilation in this case. Similarly, using a standard bag-mask device without modification to connect to the stoma would also not provide the necessary fit and security; those devices are more suited for traditional airway management where the anatomy aligns with normal jaw and facial contours. Lastly, inserting an oropharyngeal airway is not effective with tracheostomy patients since they do not have a route through the mouth to the lungs due to the presence of a stoma. Therefore, utilizing the appropriate adaptor is key to facilitating effective respiratory support.