So I was with the Anesthesiology Attending making some 'rounds' with post-op patients we had taken care of yesterday. As we entered the room a nursing student was present in the room already by the pt's bedside. Please keep in mind that the pt is a 60 s/p Laryngectomy, Pharyngectomy (had Ca of Larynx). At any rate the pt had a trach that was put in yest. Clearly, not enough time for the trach/stoma to epithelize a tract etc. At any rate, nursing student was doing here nl stuff checking drains,etc. All of a sudden she removed the trach to look at the stoma. BAAM, stoma is almost shut tight. Pt is gasping for air. What do you do? And no...changing your diapers is not an option.