I put this page up because if I'm ever found face down in my pasture, I'd like the fella who finds me to know what to do. Most people have never met a neck breather. Most CPR classes spend about a minute on us, if that. So here it is, plain. I am an auctioneer, not a paramedic. This is what our club's retired nurse, Marguerite, went over with our county rescue squad last spring, and what my own doctors have told me. Take a CPR class. Ask your instructor about neck breathers. That's the best thing you can do.

• A round opening, the stoma, low on the front of the neck, just above the breastbone.
• Often covered: a cloth or foam cover, a bandana, an ascot, a scarf, a turtleneck. Look under it.
• A medical ID bracelet or necklace, a wallet card, or a sticker in the car window that says something like NECK BREATHER or LARYNGECTOMEE.
• The person may not be able to speak at all, or may talk with a buzzing device held to the neck, or in a low, breathy voice.

After a total laryngectomy, like mine, the windpipe opens only at the stoma. The nose and mouth are no longer connected to the lungs at all. Tilting my head back won't open my airway, and blowing into my mouth or nose won't get one breath of air to my lungs. The stoma is my airway.

Some other people have a stoma or a tube in the neck but still have a voice box. They're partial neck breathers, and air can still go in and out through their nose and mouth as well as the neck. That makes a difference in what you do (see below). If you can't tell which kind you've got, treat the neck as the airway and watch the chest.

FIRST: Call 911, or send somebody to call. Tell them: "The patient is a neck breather."

• Give oxygen at the stoma, not with a mask over the nose and mouth.
• Suction through the stoma, not the mouth.
• If the person has a voice prosthesis (a small valve inside the stoma, on the back wall), leave it be.
• A laryngectomee can't call out for help, and on the phone may only be able to buzz. Don't assume a silent call is a wrong number.
• Talk to the patient. We can hear fine. Give us a pad and pencil if we can't get to our buzzer.
• Ask your training officer to cover neck breathers. Some laryngectomee clubs will send members to your squad meeting to talk and answer questions. Ours did, and we brought pie.

Neighbors: if you know somebody's a neck breather, just remember the one thing: the neck is the airway. That alone might save his life.

Fellow neck breathers: wear your medical ID. Every day. Put the card in your wallet and the sticker on your car. Tell your family and the folks you work or play cards with what to do. Make sure your local rescue squad knows you live there. Ours keeps a list.