manual disimpaction

[1louise1]

so...tonight i had a patient who was an obligate nose breather with 2L O2 per NC. i noticed he was tachypneic, and somewhat labored, so i contacted the RT to see if she thought his breathing was becoming worse. after her assessment, she told me that he seemed dry, nasally, and when she inspected his nares, she noted a large, dry booger that was most likely obstructing his right nare. so i grabbed my penlight, flushes, swabs, and tweezers and had a nauseating time trying to remove this obstruction.

anyone have any experience with this? what to do?!?! oh yeah, this guy was nonverbal, immobile/contracted, so i was trying to do him a favor....i would want my nose picked too:o

[stephie_love]

In my opinion, you did the right thing. Could you imagine if the nurse responded to you, as you watched your love one choking to death on their own mucus, "oh, we just have to let him go naturally..."

Yuck. What kind of nurse would allow someone to go that way.

[1louise1]

yes i agree....suctioning falls under comfort care. isn't it all about dying with dignity? i've never heard of choking as a natural cause of death.

and i hate suctioning too, but a mucus plug the size of a pen light? fascinating.

[TiffyRN, BSN, PhD]

Seemingly very small mucous plugs can cause rapid decline in a premature infant. I often extract what seem like tiny plugs but they are occluding 1/2 or more of their tiny airways so they are very significant. Most of the time I perform the extractions with bulb suctions or infant size yankeurs. Sometimes you wind up doing the final removal with your fingers (gloved!).

[arabianeyez83]

Reading this gave me a visual and i gagged..thanks lol...I can't do mucous, I turn my head when i can when I'm suctioning a trach...yuk