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Carrying a neck breather alert card after laryngectomy | CION Cancer Clinics
A neck breather alert card tells anyone helping you that you breathe only through the opening in your neck. After a total laryngectomy, mouth-to-mouth and an oxygen mask over the face do nothing for you, and you may not be able to say so. This page covers what the card should say, where to keep it, and what your family should practise before it is ever needed. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- What is a neck breather alert card, and why carry one?
- What the card should actually say
- How to make sure the card is found when it is needed
- Why the card must say which operation you had
- Three things families tell us about the card, and what is actually true
- What the card cannot do, and what to do next
- Common questions about the neck breather card
The short answer
What is a neck breather alert card, and why carry one?
A neck breather alert card is a small card that tells anyone helping you that you breathe through the opening in your neck, not through your mouth or nose. After a total laryngectomy you carry it because, if you collapse or cannot speak, the people around you will otherwise do the normal thing and try to help you breathe through your mouth. That does nothing for you.
Why the ordinary rescue steps fail
After the voice box is removed, the windpipe is stitched to the skin of the neck. The stoma (the opening) is now your only airway. Your mouth and nose no longer connect to your lungs at all. Mouth-to-mouth sends air into your stomach. Oxygen held over your face goes nowhere. The card exists so that a stranger, a nurse in a district hospital, or an ambulance crew learns this in the first few seconds instead of the last few.
Who needs one
Everyone who has had a total laryngectomy, for life. It is also worth carrying if you have a tracheostomy tube after a partial operation, because some air may still reach the lungs through your mouth, and a helper needs to know which situation they are dealing with. Family members are not with you on the bus, at the temple or in the shop.
If you were not given a card, make your own using the wording on this page.
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What helpers must do if you stop breathing
Rescue breaths and oxygen go to the stoma in your neck, never to the mouth or nose. Anyone with you should clear mucus from the opening, keep your neck straight rather than tilted back, and place the oxygen mask or their own mouth over the stoma. Then call an ambulance and say clearly that you are a neck breather. Do not let anyone waste time on your face first.
Not sure whether this applies to you?
Ask an oncologistFront and back
What the card should actually say
Keep the words few and large. Someone will be reading it in a hurry, possibly in poor light, possibly with no medical training.
The one line that matters
In large letters on the front: "I am a neck breather. I breathe only through the hole in my neck. Give oxygen or rescue breaths at my neck, not my mouth." Write it in Telugu and in English, and in Hindi if you travel.
Which kind of neck breather you are
State "Total laryngectomy: no connection between mouth and lungs" if that is your operation. If you have a tracheostomy tube instead, say so, because the rescue steps are slightly different.
Also useful
- The date of your operation
- Whether you use a voice prosthesis
- The size of any stoma tube you wear
Your medical details
Your name, your blood group if you know it, your regular medicines, any allergy, and whether you have diabetes or a heart condition. A rescuer cannot ask you, and you may not be able to write.
Who to call
Two family phone numbers and the number of your treating centre. Put the family numbers first. A relative can answer questions about you far faster than a hospital switchboard can find your file.
Making it work
How to make sure the card is found when it is needed
Make it hard to miss
Laminate the card or keep it in a clear plastic sleeve, and put it in the front pocket of your wallet or purse, not buried behind other cards. Some people carry a second copy in the phone case.
Add a bracelet or pendant
A wallet may be left at home. A medical alert bracelet, pendant or even a printed wristband with "Neck breather" on it stays with your body and is where ambulance crews look first.
Put it on your phone lock screen
Most phones let you set emergency information that shows without unlocking. Add "Neck breather: oxygen at stoma" and your family numbers. A rescuer will almost always pick up your phone.
Tell the people around you
Show the card to your family, your neighbours, your colleagues and the auto driver you use every day. The card is the backup. People who already know are the real protection.
Leave a number, we will call you
One field. No form to fill in, and no charge for the call.
Side by side
Why the card must say which operation you had
Total laryngectomy
Tracheostomy with the voice box still in place
The mouth and nose no longer connect to the lungs at all
Some air may still pass through the mouth and nose
Rescue breaths and oxygen go only to the stoma
Rescuers may need to cover the mouth and nose while breathing into the tube
The stoma is permanent and does not close
The tube may be temporary and can be blocked or displaced
Commonly believed
Three things families tell us about the card, and what is actually true
"Every hospital will know what a stoma is."
Laryngectomy is not common, and a casualty doctor in a district hospital may never have seen one. The card does their thinking for them in the first minute, which is the minute that counts. It also tells them not to try to put a breathing tube through your mouth.
"I will just tell them if something happens."
If something happens, the reason may be that you cannot breathe, and a person who cannot breathe cannot speak, write or use a voice prosthesis. Even with an electrolarynx, a panicking helper may not understand you. The card speaks when you cannot.
"The card replaces teaching my family."
It does not. Your family should practise clearing the stoma and know where the oxygen goes before they ever need to. Ask your speech therapist or nurse to run through it with whoever lives with you. The card is for the people who were never taught.
Being straight with you
What the card cannot do, and what to do next
A card cannot make anyone read it. It works only if it is found, and it is found only if it is somewhere obvious. That is why the bracelet, the phone lock screen and the people who already know matter as much as the card itself.
It does not replace an emergency plan
Decide with your family which hospital you would go to, who drives, and who calls ahead. Keep your spare stoma tube, suction and humidification supplies in one bag by the door. A written plan on the fridge is not dramatic. It is simply what people with a single airway do.
It does not tell a rescuer everything
The card cannot describe your reconstruction, your tube size in every situation, or the details of your cancer treatment. It tells a stranger the one thing that keeps you alive until someone who knows you arrives. Keep a fuller summary from your surgeon in your discharge file.
What to do this week
Write the card, or ask your centre for one. Set up the phone lock screen. Order a bracelet. Then show the people you live with where your airway is, or call the helpline and we will arrange a nurse to do it.
This page is about what to carry. It cannot judge whether your own breathing symptoms are safe. If your breathing has changed, that needs a same-day review, card or no card.Questions we are asked
Common questions about the neck breather card
Where do I get a neck breather alert card in Hyderabad?
Ask the speech therapist or stoma nurse at the centre where you were operated. Many teams give one at discharge. If yours did not, print the wording from this page on a visiting-card sized piece of paper and laminate it at any photocopy shop. There is no official format, so a home-made card is just as valid.
Should it be in Telugu or English?
Both, and Hindi if you travel outside the state. The person reading it could be a neighbour, a police constable, an auto driver or a nurse. Put the one critical sentence in each language on the front, in large letters. Medical details in English on the back are fine, because hospital staff read English.
Is a bracelet really necessary if I have the card?
The card is better than nothing, and a bracelet is better than the card. Wallets get left at home and phones get locked. Ambulance staff are trained to look at the wrist and neck for alert jewellery. A simple engraved band saying "Neck breather" is enough.
What should my family actually do in an emergency?
Keep your neck straight, wipe or suction mucus from the stoma, remove a stoma tube if it is blocked, and give oxygen or rescue breaths at the stoma. Call an ambulance and say "neck breather". Ask your team to demonstrate this before discharge, and to repeat it for any new carer.
Do I need the card if I never go out alone?
Yes. The relative with you may be the one who collapses, or may be in the next room, or may freeze. The card also speaks for you at clinics and admissions for other illnesses, where a new doctor may not have read your file. Carry it always.
Will a hospital in my district know what to do?
Possibly not, which is the point of the card. Most emergency staff have managed tracheostomy tubes but far fewer have seen a total laryngectomy stoma. Your card tells them there is no route through the mouth, so they do not attempt it, and it gives them your centre's number to call for advice.
Can I put the information on my phone instead?
Add it to the phone as well, not instead. Both Android and iPhone have a medical information screen that shows without unlocking. Write the same one line there. But a phone can be dead, lost or locked in a way a rescuer cannot work out, so keep the physical card too.
What if I also have a voice prosthesis?
Write that on the card. If the prosthesis comes out, liquid can enter the airway, and a doctor needs to know the small hole between the food pipe and windpipe exists. State the type if you know it, and add that your stoma should not be blocked to make you speak during an emergency.
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Sources
- NHS — Laryngeal (larynx) cancer: treatment
- Macmillan Cancer Support — Laryngectomy
- Cancer Research UK — Living with laryngeal cancer
- American Cancer Society — Laryngeal and hypopharyngeal cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Emergency care: why mouth-to-mouth will not workThe rescue steps your family should practiseBreathing through a neck stomaHow the new airway works day to dayDaily stoma care after laryngectomyKeeping the opening clear and cleanLaryngectomy supplies and where to get themTubes, filters and the emergency bagCaretaker and family guide to surgeryFor the person who will be with you most
Talk to us
Want a nurse to go through the rescue steps with your family?
Call the helpline or send us your details. We will arrange a session with your speech therapist or stoma nurse, and check your card wording with you.