What should I do?

[rusure]

Saw a patient on a nasal cannula @ 6L o2 and a non re breathing mask. Her nose has been bleeding none stop. She is using peroxide n q tips to clear her nose once the blood drys. The nurses know that this is going on. I'm not sure what to do. I once read that on such a high level nasal cannula o2 u basically blow the brain and after 4L on a nasal cannula don't do any good anyway. What can/should I do or not do?

[leslie :-D]

The nurses know that this is going on. I'm not sure what to do.

as asked already...are you a nurse? what is your relationship to the pt?

leslie

eta: ok, i peeked at your profile and it says you're a pre-nursing student.

are you in school yet...i'm thinking you must be, or you wouldn't be asking about a pt.

[gr8txrn2b]

What can/should I do or not do?

what happened?

[Unknown member]

"One oxygen source!

Humidified oxygen.

Vasaline to the nose. "

I am a nursing student (thus I cannot give appropriate input LOL) but anyway, I've been told that we CANNOT use vasaline or the like because it has the potential to combust (this told to me by nurses and my instructors) Any thoughts?? I noticed another poster mentioned vasaline as well, but I am HORRIFIED to ever do this.

[Tait, MSN, RN]

"One oxygen source!

Humidified oxygen.

Vasaline to the nose. "

I am a nursing student (thus I cannot give appropriate input LOL) but anyway, I've been told that we CANNOT use vasaline or the like because it has the potential to combust (this told to me by nurses and my instructors) Any thoughts?? I noticed another poster mentioned vasaline as well, but I am HORRIFIED to ever do this.

Technically Vaseline is a petroleum product, therefore it has a slim chance of combustion from what I was taught in school as well. We were recommended to use water based lubricating jelly instead.

I have seen patients on NC + masks before per RT, which always confused me as well. Sounds like this needs some special attention and clarification.

[nurseprnRN, BSN, RN]

"i am a nursing student (thus i cannot give appropriate input lol) but anyway, i've been told that we cannot use vasaline or the like because it has the potential to combust (this told to me by nurses and my instructors) any thoughts?? i noticed another poster mentioned vasaline as well, but i am horrified to ever do this."

this is absolute and total b.s., and i don't mean "bachelor's of science," . it's another one of those old wives' tales that gets passed around from generation to generation and has absolutely no basis in reality or science.

if you were ever in chemistry class or scouts, you would have learned that fire requires three components: 1, fuel; 2, oxygen; 3, an ignition source.

1) vaseline is a petroleum product, and will burn (it's great on cotton balls for starting a camp fire lay in the rain-- i've done it)

2) oxygen itself does not burn (look it up if you don't believe me), it supports combustion, which is why you don't have cigarettes going near your oxygen concentrator (unless you are a tobacco-addicted copd patient who enjoys sudden visits from those nice boys and girls in your friendly local fire department)

3) unless your patient is one of those spooky people who spontaneously combusts (or sticks a lit match up his nose), it is highly doubtful, yea, impossible that vaseline in his nose will burst into flames because you have helpfully applied an effective protectant to his nares.

your instructors ought to have better critical thinking skills. are they afraid of lip balm, too (also a petroleum wax product)? also harmless.

use the petroleum jelly (vaseline). it won't dry out like ky or other water-based lubricant, so it won't accumulate in scummy sheets up in there. sterile goobers aren't any more comfortable or better than native ones in keeping airways open.

[psu_213, BSN, RN]

this is absolute and total b.s., and i don't mean "bachelor's of science," . it's another one of those old wives' tales that gets passed around from generation to generation and has absolutely no basis in reality or science.

if you were ever in chemistry class or scouts, you would have learned that fire requires three components: 1, fuel; 2, oxygen; 3, an ignition source.

1) vaseline is a petroleum product, and will burn (it's great on cotton balls for starting a camp fire lay in the rain-- i've done it)

2) oxygen itself does not burn (look it up if you don't believe me), it supports combustion, which is why you don't have cigarettes going near your oxygen concentrator (unless you are a tobacco-addicted copd patient who enjoys sudden visits from those nice boys and girls in your friendly local fire department)

3) unless your patient is one of those spooky people who spontaneously combusts (or sticks a lit match up his nose), it is highly doubtful, yea, impossible that vaseline in his nose will burst into flames because you have helpfully applied an effective protectant to his nares.

amen!! and thank you for putting so succinctly.

[Faith2012, ASN, BSN, RN]

I was in ICU for over a week and my nurses and doctors forbid me from having vaseline based chapstick. They too said it could combust or cause a fire around all the machines. I personally would listen and just to be in the safe side use something else.

[beckster_01, BSN, RN]

^^ It has always struck me as an old wives tale. When I was a tech they didn't even allow Vaseline on the floor. But I think that if my patients are actively setting themselves on fire then a petroleum-based product isn't going to make much of a difference. That being said we use water-based lubricant or A&D ointment.

I am mildly entertained by the mental picture of 6L NC "blowing a patient's brain out." But that has a lot to do with the mind-twisting 12-hour shift that I just worked. Where is the 'puking' smiley when you need it most?

[nurseprnRN, BSN, RN]

hey, it's me, the one that knows you can't cause a fire in someone's nose with petroleum jelly. ladies (and gents), this is why you took chemistry. ignoring actual science "to be on the safe side" is, um, not evidence-based nursing. those icu mds and nurses are wrong on the face of it, and you can tell them why by printing out the post above.

and a&d? what's that made of? (wait for it....)

yes! petroleum jelly! didja have a lot of nasal flames in that unit? i thought not.

[canoehead, BSN, RN]

RT consult, even as a student you can pull one aside and ask about whats going on with the two O2 delivery systems. Let them take it from there.

[ProgressiveActivist, BSN, RN]

Over 4 lpm nc requires humidification.

If this patient is a full code, I would request an ABG and proceed from there. If they are hypoxic, BiPAP is the next step. Bacitracin in the outer nares is what I would do to relieve dryness.

[MomRN0913]

I put vasoline on my patients lips all the time int he ICU. One Dr even wrote it as an order.