Vap

neuro23 · Jan 21, 2007

Pretty much the same in our Neuro ICU in Edmonton ... HOB @ 30, OG vs NGTs, oral care: cleaning the tongue and teeth (where possible) with a toothbrush + toothpaste Q12h + mouthcare Q2H using toothettes with chlorhexidine mouthwash & suction. We also started using EVAC tubes (which sxn secretions above the cuff) about 5/52 ago. The Q2H mouthcare is also important in maintaining long-term patency of the EVAC tubes.

Flockone · Feb 8, 2007

Neuro ICU nurses: What do you think about increased VAP

due to the patients lying flat for multiple CATT scans and repeated angios possibly causing aspiration??

neuro23 · Feb 8, 2007

Neuro ICU nurses: What do you think about increased VAP
due to the patients lying flat for multiple CATT scans and repeated angios possibly causing aspiration??

Honestly, I'd never thought of that. I don't think most vented patients could be positioned lying at 30 degrees in a CT scanner because the head wouldn't be centred in the gantry. I'm sure a 30 degree position would be possible in our angio suite (biplanar with 3D reconstruction). I also think the incidence of VAP may be decreased by suctioning and cleansing the oral cavity before transferring the patient to the CT or angio table. If a patient with an ETT must remain supine (for whatever reason), maybe placing a couple of throat packs (or any easily removable absorbent swab) might help -- might need McGill forceps. Great point though!

Neuro.

TxMadeRn · Sep 17, 2011

This may be a stupid question. But im reading up on VAP, and it says that we would want to use an orogastric tube instead of a naso gastric to reduce the patients risk of getting VAP. Im trying to figure it out but i can't function without coffee. Can someone help me out as to why we would use the orogastric tube. thanks in advance.

mpccrn, BSN, RN · Sep 17, 2011

oral gastric tubes decrease the changes of sinus infections. By bypassing the nose you deminish the risk.