Intubated Pt's Using Bedside Comodes

ShaunES · Mar 29, 2011

I've walked intubated patients around the unit with a transport ventilator, so no, using a bedside comode isn't that crazy an idea.

Not every intubated is unstable, if you have the resources and time to do it safely, do it!

(The procession for the walk was pretty funny, myself, two other nurses, two wardsmen, another wardsmen pushing an oxford recliner chair, and another with the oxygen)

This is ICU mind you, down in emergency I wouldnt even dream of it :)

blackandyellow · Mar 29, 2011

I haven't seen it on our floor but then again we have had patients that will update their facebook statuses while intubated and text message. ShaunES- I have to admit I laughed a little at the thought of an intubated patient walking around on the unit with a parade of people following him/her. That must have been a little nerve wracking!

GreyGull · Mar 30, 2011

We have stable intubated patients sit in a bedside chair and ambulate around the unit. A bedside commode is also a possibility. Some try to manage their own ventilators and a few COPDers probably could do a better job.

tablefor9, RN · Mar 30, 2011

3 words: Ready for step-down!

Biffbradford · Mar 30, 2011

3 words: Ready for step-down!

More like ready for a trach.

GreyGull · Mar 30, 2011

Some patients are on the vent because of COPD or asthma exacerbation and may need to do some moving. Others might have a pleural effusion that needs tapping and then waiting for re-expansion before pulling the tube. Some are delayed extubation because the need another surgery later that day or the next and it saves reintubation. If a patient can move, so much the better.

I think one of the things extending length of stay on vents now dispite all the new technology is because of the technology. We have ventilator modes that do everything for spontaneous breathing trials and we are no longer walking vent patients in "bag and drag" fashion as we did in the 70s and early 80s. We have beds which also maneuver the patient with very little effort on their own. Even the old fashioned hands on CPT is a thing of the past. Patients are now coming off the vents and requiring extensive SNF stays with rehab to get moving again.

msmiranda21 · Mar 31, 2011

A bed pan-most likely, but not bedside commode on a tubed patient!

NtannRN · Mar 31, 2011

I haven't gotten an intubated pt. Oob since I was an aide 18 yrs ago.i think if I suggested that now the other nurses would want me to get a psych consult! Lol. We have a10-14 day limit, then it's a trach and peg. Honestly,i don't think we have enough staff anyway to walk them. Lately, with all the different documentation we have to do, the unwillingness to pay overtime and working short staffed,i am thank full for my continual rotation bed that does crappy cpt.

GreyGull · Apr 1, 2011

Doesn't anybody even sit their intubated patients in chairs at the bedside? It could prevent the patient from needing a trach. A trach should not be the answer for laziness or using other excuses for not doing what you can to get a patient extubated. Complain all you want about your working conditions but it is the PATIENT who suffers. You still go home while the patient is connected to a ventilator waiting for PNA and a trach which may mean that is the end of their life as they knew it.

Nccity2002, MSN, RN · Apr 1, 2011

Ok...a few days ago an ICU nurse, at my facility, stated that stable intubated patients on the Unit use bedside comodes. My first thought was you are joking, right?! No, she was serious! I don't pretend to be an ICU nurse or know the aspects of care that pertain to ICU nursing but in the ER I would NEVER place an intubated pt on a bedside comode for obvious reasons, they are not stable. Can any ICU nurses out there back up her statement? For some odd reason, I keep picturing an intubated patient on a bedside comode and find it HILARIOUS! I think I need to see this to believe it!!

Hi EDrunnerRN,

It is uncommon, but yes, in my experience I had assisted ventilatated patients to a chair ; and in one or two occasions, to a bedside commode. As long as the patient is stable, it should not be a problem.

miss arron · Apr 4, 2011

The majority of intubated patients I've had would yank that tube out the second the restraint is loosened let alone if attempted to get them up to a bedside commode, or desat the second you lower the HOB or turn them.

Theoretically speaking, if the patient is stable and cooperative I would consider a bedside commode - just haven't seen a situation where it would even be considered.