Am I the only person who will not give ice to their intubated patient?? I had just come on shift earlier this week and a family member asked for ice for the patient who was on a vent. I said no, can't have any, on a vent, potential for aspiration, la...la...la.
They said the nurse before gave it. I said that I am not comfortable with it and wouldn't do it. The nurse before me said that the ANESTHESIOLOGIST gave it to the patient when he was in to do a procedure (not the intubation) and said it was ok for him to have "a little".
This has happened to me more than once. Am I crazy for not allowing this?
i don't ever give ice to a vented patient. are a couple of chips of ice really worth the risk of aspirating? no! the patient can wait until the tube is out. let's get the priorities straight, here.
secondly, i just attended a critical care course on vents taught by a rrt who has a phd in education. she is faculty at the local rt school, and is really into evidence based medicine. she said the routine use of saline during suctioning is prohibited in the most current literature. she was very aggressive about getting this point across to a room of icu nurses. if i can find her articles, i will post them.
crazypremed
what the heck, here are some studies:
crit care med. 2008 nov 28. saline instillation before tracheal suctioning decreases the incidence of ventilator-associated pneumonia.
am j crit care. 2008 sep;17(5):469-72. instilling normal saline with suctioning: beneficial technique or potentially harmful sacred cow?
pediatr crit care med. 2008 sep;9(5):465-77. a comprehensive review of pediatric endotracheal suctioning: effects, indications, and clinical practice.
Specializes in Trauma acute surgery, surgical ICU, PACU.
I wanted to kill a doctor recently who told a patient (without asking the nurse) she could have ice chips. This was a lady who was gagging on her tube, and we had not been able to get an NG in yet - and she was one of the angry types who would get mad if you didn't give her more - she would have had "all the ice she could hold" in two seconds if I had let her!
CrazyPremed, MSN, RN, NP
332 Posts
i don't ever give ice to a vented patient. are a couple of chips of ice really worth the risk of aspirating? no! the patient can wait until the tube is out. let's get the priorities straight, here.
secondly, i just attended a critical care course on vents taught by a rrt who has a phd in education. she is faculty at the local rt school, and is really into evidence based medicine. she said the routine use of saline during suctioning is prohibited in the most current literature. she was very aggressive about getting this point across to a room of icu nurses. if i can find her articles, i will post them.
crazypremed
what the heck, here are some studies:
crit care med. 2008 nov 28. saline instillation before tracheal suctioning decreases the incidence of ventilator-associated pneumonia.
am j crit care. 2008 sep;17(5):469-72. instilling normal saline with suctioning: beneficial technique or potentially harmful sacred cow?
pediatr crit care med. 2008 sep;9(5):465-77. a comprehensive review of pediatric endotracheal suctioning: effects, indications, and clinical practice.
intensive crit care nurs. 2008 jul 14.
endotracheal suctioning of the adult intubated patient-what is the evidence?
although it seems like there is some disagreement, i tend to see more articles that recommend not using saline than those that do.