What is the recommended action for administering breaths to a tracheotomy patient with a BVM?

For a tracheotomy patient, the proper method of delivering breaths using a bag-valve mask (BVM) is to administer the breaths directly over the stoma, which is the opening created by the tracheotomy. This is because the tracheotomy bypasses the upper airway structures, such as the nose and mouth, which means that sealing these areas or attempting to administer breaths through them will not be effective.

When using a BVM on a patient with a tracheotomy, directing the breaths over the stoma allows for effective ventilation directly into the trachea, ensuring that oxygen reaches the lungs. This method is critical in maintaining adequate ventilation and oxygenation for the patient. It's also important to ensure that the mask fits snugly around the stoma to avoid any air leaks, facilitating better breath delivery.

The alternative choices do not apply to tracheotomy patients as they are designed for situations involving normal airway anatomy. Therefore, administering breaths directly over the stoma is the necessary and correct procedure for providing effective ventilation in this scenario.