[OkieICU_RN]

Am I the only person who will not give ice to their intubated patient?? I had just come on shift earlier this week and a family member asked for ice for the patient who was on a vent. I said no, can't have any, on a vent, potential for aspiration, la...la...la.

They said the nurse before gave it. I said that I am not comfortable with it and wouldn't do it. The nurse before me said that the ANESTHESIOLOGIST gave it to the patient when he was in to do a procedure (not the intubation) and said it was ok for him to have "a little".

This has happened to me more than once. Am I crazy for not allowing this?

[oMerMero]

I just have to wonder if the family is not telling the truth. Perhaps they saw someone doing oral care and thought the nurse put ice in the mouth, or maybe they really believe the patient needs ice so they are going to make up a story to try to get you to do. I just do not want to believe nurses and doctors are giving ice to an intubated patient. When the ice melts to water, where is the water going to go?

[OkieICU_RN]

Yes, my point exactly. And let me clarify.....the nurse before me was still there and said she gave him 1 or 2 ice chips and he did fine with it. She is the one that told me the anesthesiologist gave the patient ice earlier.

[sharrie]

I have given small amounts of ice to awake intubated patients for very short periods of time, in the unit that I worked it was considered acceptable as part of mouth care. This was only allowed for very short periods and certainly not long enough for the ice to melt or cause aspiration problems. The pateints were not permitted to suck the ice until it dissappeard just enough to have something cool and moist within their mouth for comfort.

[Brooke1984]

I agree with you, I am not comfortable giving ice chips to intubated patients whatsoever....don't feel to bad, i don't know any nurses on my floor who would either.

[loafin']

Why not give ice? The airway is protected and pt's can't aspirate unless the et tube cuff blows or et tube comes out. On any intubated pt there are secretions setting on top of the et tube and that's one reason we tell them to cough as we extubate as not to aspirate the secretions.

[stressgal]

I will never forget a frequent flyer COPDer who was intubated, unsedated, sitting on the side of bed, drinking soda through a straw (her family had provided).
I FREAKED OUT, but she was able to handle liquids while intubated. The cuff was inflated, airway protected, swallow intact. This was not her first time with an ET tube and she had the right to decide for herself. I did talk the family and patient out of carbonated beverages, made me feel a bit better. LOL!

[deeDawntee]

HOLY MOLEY!!
You've got to be kidding me? I have never heard of such a thing!! At my institution, if a person was that active, they would be extubated and on a bipap if they needed it for support. I can't imagine that ever happening where I work (unless of course they were a trached quad).
I can see where it could be done, but it is a little freaky!!!

[SICU Queen]

I will get a cup of ice water and use a swab in the patient's mouth; it gives the same effect and provides mouth care at the same time.

Honestly, one tiny piece of ice is no more water in the mouth than doing mouth care with a swab. It just seems so wrong to give ice to an intubated patient though!!

[danamobile]

Originally Posted by loafin'

Why not give ice? The airway is protected and pt's can't aspirate unless the et tube cuff blows or et tube comes out. On any intubated pt there are secretions setting on top of the et tube and that's one reason we tell them to cough as we extubate as not to aspirate the secretions.

when a patient coughs, or when we make them cough during suctioning, it makes the seal where the cuff is located not be a seal any longer, this is why the vent alarms when your patient is coughing--well the change in pressure and/or volumes. secretions sometimes get coughed into the mouth as well.so no, you are not entirely correct by saying they cannot aspirate. a lot of folks have swallowing difficulties and have no reflexive gag if they aspirate fluid into the lungs. the cuff is not 100% airtight and patients cough/made to cough many times a day. not all secretions and/or fluid can be suctioned off of the cuff with the VAC or suctioning to the back of the throat either. as well, you need swallowing to make sure that any trickling fluids go down the esophagus rather than to the lungs which is something you cannot guarantee as for the aforementioned. its pretty difficult to swallow with an ETT in your mouth, as well if your mouth is dry, and sedation/analgesics.with that, i say no to ice and venting. i say no to any npo status unless specifically ordered. i introduce all fluids if ordered them from npo from very thick and work my way to thin. apriration only leads to longer stays. if we dont prevent it, ppl will always just think ice is ok.and ice melts the second the temperature is not freezing, so it melts pretty much instataneously in the mouth. and it is much different than giving mouthcare! i dont know about what others do, but i squeeze out swabs before i give them to prevent dripping of water, and if i brush teeth, i use the yaunker int he back of the thraot to prevent it rolling to the back of the mouth!