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Discussion

Mouthcare

I am returning to the ICU setting after being gone for 5 years. One thing that has always bothered me was to see a patient with a dried out mouth. Some nurses are better at mouth care than others. I found, as I did my mouth care diligently, was that some patients just had drier mouths than others due to various reasons. My question is what have you found to be the best solutions, etc to do mouth care on a ventilated patient?

Thanks

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The research with mouthcare (or lack thereof) and incidence of ventilator-associated pneumonia is staggering. I brush the teeth of ventilated patients - with more than just some spongy thing - an actual toothbrush. Then I use the spongey thing to rinse the mouth out (our hospital has a packet with the spongy thing and toothbrush on one stick and a packet of mouthwash and toothpaste) and put vaseline on all lips.

For patients who have severe problems with a dry mouth for whatever reason, you can put vaseline in their mouth also.

The main thing is keeping on top of it. It really depends on the patient. Some patients may need it once every 4 hours and some may need it once every half an hour.

We have some mouth moisturizer that we use pretty regularly along with BID brushing and Q2 rinses. It can be applied with a sponge. It's water based, which is less corrosive than vaseline (petroleum based) - which we don't even stock - and would never use for oral care, anyway.

I am sorry - it is special "mouth moisturizer" which comes in packets in the oral care packet I refer to practically everything like vaseline as "vaseline".

I cant tell you how many patients who have been NPO for 12 hours come to the PACU with food and junk stuck and dried to dentures. .It is gross yes, but I just cannot see putting those yucky things back in their mouths unless they are clean. I usually rinse them well at least. We don't have the chance to brush teeth too often in PACU but we are very stringent about mouth care before returing a patient. Poor floor nurses have too much to do already so what can I say?

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