How to Palpate a Stoma

A tracheotomy is a medical procedure in which an incision is made in the front, or anterior aspect, of the throat. The incision is made to gain a direct access route to the airway. A tube can be inserted at the site of the incision to create permanent airway access. The tube that is put in place is referred to as a tracheostomy tube, or a stoma for short. A stoma eliminates the use of the mouth and nose during breathing. Permanent tube insertion is used to assist breathing after surgery to treat throat cancer. Palpation can provide key information about the condition of the internal structures of the trachea.

Things You'll Need

• Disposable gloves

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Instructions

• 1

  Wash your hands using soap and warm water. Put on gloves before any contact is made with the stoma. This will prevent the spread of germs and infection.

• 2

  Inspect the area visually. Look for any tracheal deviation. The trachea should be straight and located mid-line on the neck. Look at the color of the skin. Redness and swelling indicate infection. Broken skin and irritation can also be a sign of infection.

• 3

  Check the stoma for drainage. If drainage is present, make a note of the color and consistency. Pink tinged secretions indicate bleeding. Thick secretions present in excess amounts can indicate an overflow of fluid volume. Copious secretions need to be suctioned if they impede the flow of oxygen. Dry, thin secretions indicate dehydration.

• 4

  Use two fingers and gently palpate the area around the stoma. Look for a grimace or painful reaction in the patient. Pain may indicate an infection or improper placement of the stoma.

• 5

  Move fingers down each side of the trachea. Feel for areas of subcutaneous emphysema. Subcutaneous emphysema is air trapped in between layers of skin and muscle. These areas feel like crispy rice cereal.

• 6

  Check the stoma to make sure it is securely taped in place. One finger should be able to fit under the collar of the stoma. An tube that is not secured can be dislodged by everyday activity. Secure the stoma using tape and sterile dressing.