During clinical today, we had a patient who was NPO and on a thicked diet. She was practically begging us to bring her some water. We explained the risks of thin fluids and instead brought her some gelled oj and water. We thought maybe we could give some ice chips which would at least help her dry mouth and refreshen it a bit, but then thought the ice would melt and possible cause her to aspirate. What do you guys do in your practice for dysphagic patients who really want hydration, but can't stand the thickend fluids. Shes not on an IV either. By the way, my friend and I tasted some gelled water and it was pretty horrible
Mar 1, '05
If you have OT at your hospital, they are a great resource. They do swallow evals at my hospital, and are well educated about swallowing disorders.I have learned so much from them, as some liquids that you think are safe may actually be a danger. You do have to be careful, as jello and ice chips are actually considered thin liquids...once they melt in the mouth. It may not be safe to give thin liquids to your patient. They might be silently aspirating on it! There's a reason why they are recommended to have thickened liquids.
Always find out what kind of liquids the patient can have, and what precautions need to be taken (i.e. straws versus no straws, HOB at 90 degrees etc). Where I work, OT posts a big sign over the bed reminding of precautions for dysphagia patients after the swallow eval is done (it is also posted in the Kardex). You can usually use those oral swabs (Toothettes) lightly moistened with supervision for dry mouth when in doubt. NPO means Nothing by Mouth! in my book- no jello, ice chips etc. If Doc writes for NPO except ice chips, that's different. I do oral care with the toothettes for NPO patients. But why was your patient NPO? Was it pending a swallow eval or for a procedure? I know it is hard for patients to be NPO, but think of safety first.
Last edit by Genista on Mar 1, '05