Ventilator pt chokes on food

Caffeine_IV · Jan 20, 2014

A patient on a ventilator is not able to have food by mouth.

TiffyRN, BSN, PhD · Jan 20, 2014

Really? Can't eat? Years ago I had a longtime complete C2 injury vent dependent patient that didn't have a g-tube and kept getting fatter & fatter. Tacos, burgers, beer, whatever he could talk his family into feeding him he ate. Not totally sure if you can effectively do heimlich on a trached pt; seems you might risk dislodging the trach as well as food. Suction the trach?

Caffeine_IV · Jan 20, 2014

Really? Can't eat? Years ago I had a longtime complete C2 injury vent dependent patient that didn't have a g-tube and kept getting fatter & fatter. Tacos burgers, beer, whatever he could talk his family into feeding him he ate. Not totally sure if you can effectively do heimlich on a trached pt; seems you might risk dislodging the trach as well as food. Suction the trach?[/quote']
I was referring to patients with an ET tube not sure about the OP.

JustBeachyNurse, LPN · Jan 20, 2014

If it's a cuffed trach it would be a non-issue. Suction better option than abdominal thrusts less risk of dislodging trach. If ET tube, tube is cuffed so not possible to choke as cuff prevents secretions, food, etc from getting in airway

All patients with trach or trach/vent at home have suction readily available

bcassella2007 · Jan 20, 2014

My patient is able to eat food by mouth. Uncuffed trach. I know I would suction but what if it was a jawbreaker that was stuck? I would assume that I'd do the Heimlich maneuver but I've been unable to find any nursing info on this.

JustBeachyNurse, LPN · Jan 20, 2014

My patient is able to eat food by mouth. Uncuffed trach. I know I would suction but what if it was a jawbreaker that was stuck? I would assume that I'd do the Heimlich maneuver but I've been unable to find any nursing info on this.

Why on earth would you give your patient a high choking risk item like a jawbreaker?!?!?! Of course you won't find an answer as the answer is don't give your patient a jawbreaker? In your profile you state you work in pediatrics even more of a safety risk in pediatric patients !!

klone, MSN, RN · Jan 20, 2014

Yes, I was just going to ask the same thing. How about don't give a vented patient hard candy?

smartnurse1982 · Jan 20, 2014

Hmmm...my pt is vented and he is 22. He eats everything,including milk duds candy.

He doesn't have a cuffed trach either.

Many ENT's in my area are actually doing away with cuffs on all trach pts.

One told me the cuffs cause tracheal erosions and that they are extremely hard to treat.

So any pt that comes to her with a cuff is instantly decuffed,including peds pts.

bcassella2007 · Jan 20, 2014

Look, I'm just asking for some answers, not smart remarks! My pt is a child. What if SHE eats a hard piece of candy and chokes or eats ANYTHING that you can't suction out w a catheter? Glad I could go to fellow nurses for input. I just wanna make sure that doing the Heimlich won't cause harm. We are supposed to help each other.

bcassella2007 · Jan 20, 2014

Thank you for not having a nasty remark.

JustBeachyNurse, LPN · Jan 20, 2014

Look I'm just asking for some answers, not smart remarks! My pt is a child. What if SHE eats a hard piece of candy and chokes or eats ANYTHING that you can't suction out w a catheter? Glad I could go to fellow nurses for input. I just wanna make sure that doing the Heimlich won't cause harm. We are supposed to help each other.[/quote']
You need to check with her pediatrician /pulmonologist /treating physician to see if safe for your patient. Even when I googled most children's hospitals state if obstruction cannot be relieved by suction or trach change call the on call attending or 911.