mouth care for vent patient

Specialties MICU

Published

hi every body,

I want to ask about the best mouth care can be delivered for a vent patient, specifically teeth brushing...my instructor said it is better not to use the brush for those patient beacause it leads to a certain harm...any idea what kind of harm it could be..

any help will be appreciated

We use a soft toothbrush once a shift and 2-4 hrly Chlorhex mouthswabs in between.

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I don't see any harm in it. My hospital policy is oral care is required and documented every 4 hours to prevent VAP. We also have the neat toothbrush kit that connects to suction.

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Specializes in cardiac/critical care/ informatics.
hi every body,

I want to ask about the best mouth care can be delivered for a vent patient, specifically teeth brushing...my instructor said it is better not to use the brush for those patient beacause it leads to a certain harm...any idea what kind of harm it could be..

any help will be appreciated

Brushing teeth while on the vent is done bid and basic mouth care is done q2 hours, this is part of protocol to fight VAP.

So your instructor may be a little behind the times.

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Specializes in LTC.

The toothbrush could actually scratch gums and that leaves your patient wide open for different bacteria to enter his body (ex: vre, mrsa,staph) and thats just a few, your best bet is to use the mouth swabs they offer dipped in either paroxide or lemon glycerin

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Specializes in cardiac/critical care/ informatics.

Not according to evidence based practice and the literature out there.

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Specializes in Med-Surg Nursing.
our hospitals to cheap for that cool space-age stuff. nothing but mouth swabs, h2o2/h20 and wall sxn for us.

Same here!

mouth care on Vent patients should be done every two hours to help prevent VAP

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Teeth cleaned TDS (so once a shift) and mouth/eye care 2nd hrly

Normally, I will clean teeth just prior to changing tapes. We have kiddies toothbrushes (nice and soft, and small enough to fit into a mouth already full due to an ETT) and toothpaste, and we brush gently. Then irrigate the mouth with a yankeur sucker and syringe with an irrigation nozzle.

I'm liking the sounds of the toothbrush hooked up to suction, sounds very cool!

Mouth care is 2nd hrly swabs with H2O/Sodi Bic, lanolin to lips and suctioning of oropharynx. Of course, thats just a minimun, if pts need it more/less frequently, alter care accordingly

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i had a long term neuro pt who actually bit her tongue nearly in half--make sure you assess that mouth before you grab the toothbrush and suction!! I prefer swabs (more gentle than a brush) q2.

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Specializes in Med-Surg, ICU.
You shouldn't be brushing so hard that it causes bleeding!

Sometimes it doesn't take much to cause bleeding in the end-stage liver pt or the pt with DIC. On these pt's, I just use the swabs, gently.

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Specializes in Cardiac.

I think people have more critical thinking skills than to use a toothbrush on DIC pts...

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Specializes in CTICU.

Most important thing is prevention of VAP. I am not sure why everyone is inventing their own protocol - use the CDC VAP prevention bundle.

There is just so much literature out there about best EBP for intubated patients, there's not really any excuse for confusion.

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Specializes in critical care.
http://www.lhsc.on.ca/critcare/ucicu/procs/oralcare.htm

this website includes guidelines for oral care for intubated patient to prevent VAP...besides of course head of bed elevation and hand washing.

another issue her is the chlorhexidine which is recommened only for cardiac patient, not all intubated patients which I have just known and I am worried about it b/c all our ICU patients we use chlorheidine..

regards

the article is gone:cry:

I was curious to read it because we just implemented the chlorhexidine and some of us have had concerns.

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