When and how should I perform mouth-to-stoma rescue breaths?

1. Check the person’s neck to see if he or she breathes through a stoma, an opening in the skin, by the neck, that leads directly into the breathing passages.
2. Expose the person's entire neck down to the breastbone. Remove anything covering the stoma that blocks the airway. Also wipe away any secretions or blockages.

To perform rescue breaths:

• Make an airtight seal with your lips around the stoma or tracheostomy tube.*
• Blow in for about 1 second to make the chest clearly rise.
• Give rescue breaths into the stoma at the same rate you would breathe into the mouth when performing CPR.
• Keep the airway in a neutral position, and look, listen and feel for breathing with your ear over the stoma.
• Do not allow the chin or head to flex forward toward the chest or extend backward.

Your rescue breaths are successful if you see the chest rise and fall, and you hear and feel air escape from the stoma.