Suctioning a Choking Patient or Resident

[Plagueis]

Hi. I'm a recent LPN school graduate who is working at a new facility that has a nurse stay in the dining room just in case a resident chokes. There is also a portable suctioning machine available in case a resident chokes. However, at other facilities that I've been to, there was no suction machine in the dining room, and the nurses who were monitoring the dining room said that they are to use the Heimlich maneuver/CPR in case a resident is choking/unresponsive. They stated that they didn't know why a suction machine wasn't available. Therefore, I'm wondering about a few things that anyone can answer:

1. What is your facility policy regarding a choking patient or resident? Do you use the Heimlich maneuver first, and then suction?

2. Is there a policy that a resident needs an order for suctioning in an emergency situation?

3. What is the procedure if the patient is choking on pureed foods or liquids? I've had one nurse tell me that she used a suction machine, but another told me to use abdominal thrusts.

Thanks.

[leslie :-D]

no one can "choke" on liquid.

heimlich is for obstruction only.

if a pt aspirates on liquid, suction is ineffective since it is already in their lungs.

off hand, i cannot think of any indications for suction in a dining room.

leslie

[morte, LPN, LVN]

you cant tech. choke on a liq, but it can send the vocal chords into spasm.....never thought much about the suction machine in the dining room scenario....does make sense that it wouldnt seem logical....

[NurssNicole]

I have personally had a very good experience for use of a suction in a dining room. I think it is a great asset to have. While working on a dementia unit, one wheelchair bound lady quite heavy-set around her abdomen began choking on chewed up chicken. She was coughing initially but then began to panic and turn blue. It was apparant that she was no longer getting any air in, we tried the abdominal thrust from the w/c...ineffective completely. We transferred her to the floor and did thrusts there. 911 was already on the way by now but there had to be something more we could do. Nothing was visible in her mouth. I yelled for one of the aides to go grab the portable suction machine in the med room. Let me tell you, within 20 secs, the suction machine miraculously caught a corner of the chewed dry chicken and I was able to suck the plum-sized ball of cut up meat out. Thank God for that suction! (by the way, her diet was promptly changed to puree after that!)