course of action for pt who cannot expectorate mucous

[greatshakes]

Hi

What is the course of action normally taken by RN's to be followed in the case of someone who cannot cough effectively (for example MND). This patient was having trouble clearing secretions and felt as though he was choking. Can you please help? I would have thought; raising the head of bed, cupping and followed by suction. Is this correct? When he was home I used a ventolin puffer to try and dilate the airway as I had no suction equipment and it appeared to work. However what would be done or should be done in a LTC situation?

[papawjohn]

Hey Hassled!!!

Well, I was gonna dash off an ICU nurse's response to ya. But the Mrs is a nurse in LTC and she's sittin' right here. She suggests that she'd give a nebulizer and if that didn't work and the 'choking' continued--that she'd suction the oral-pharynx with a hard 'yankaur' or 'tonsil' suction to stimulate a strong cough and aspirate the secretions.

If the 'choking' seems very serious, the ICU nurse's approach is to take a soft plastic suction catheter with a bit of water-soluble lube and stick thru his nares into the back of his throat and with luck into his trachea and suction

ALL THAT CRAP out of his airways. It can be traumatic (for both parties) in the beginning. But it has the benefit of the direct approach.

Papaw John

PS: What's MND?

[greatshakes]

Thanks for that Pawpaw John and and thank your missus too. The RN came in and stayed three minutes and disappeared. To me that's no action and no action amounts to negligence right?

[sirI, MSN, APRN, NP]

Hello, Hassled,

I am sorry, but you really need to seek legal counsel if you are wondering if an action or lack of an action is negligence. The members of allnurses.com cannot give you this type of legal advice.

Please know we care and hope you can get this resolved. Good luck.