What product should be used to perform oral care on an unconscious person?
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The best way to make a person feel better, in addition to toothbrushing is to provide frequent fluids while they are able to drink and when that is no longer possible, ensure that the mouth is kept moist. Show
Try simple salivary stimulating measures such as unsweetened drinks, sprays, moisten lips If symptoms are not relieved consider topical saliva substitutes . It must contain the salivary enzymes lactoferrin and lysozyme which is essential for boosting the natural immune process. Avoid glycerin as it dehydrates the mucosa and lemon juice exhausts saliva secretion and acidic foods eg. pineapple or acidic artificial saliva products on people with teeth. Carers should be mindful that dry mouth may make it more difficult for certain oral medications to dissolve intra-orally or be swallowed by patients. This may require address, for example if medication gets stuck to the soft tissues cheeks and other soft tissue in the mouth.
Hydration and nutrition status should be assessed as part of mouth care. Hydrate with water /ice chips to reduce mouth dryness and make patients more comfortable to help manage bacterial growth. Consider highlighting the importance of removing and cleaning away debris, secretions and plaque regularly as part of mouth care, to maintain good oral hygiene and prevent pain and infection. Halitosis- Good oral hygiene -clean tongue, good care of dentures Fluid intake, Exclude garlic & onions, Smoking cessation , consider saliva supplements if pt has a dry mouth, Treat underlying cause - mouthwash containing antimicrobial agent. Oral Candida infection. Manage local and systemic risk factors for oral candida infection in conjunction with anticandidal treatment. Manage local and systemic risk factors in conjunction with anticandidal treatment. The choice of drug treatment may be directed by local policy or based on advice from local microbiologist. For NICE Guidelines treatment and when to refer to NICE Guidelines [March 2021] here Mouth Ulcers and mucositis Depending on the severity of pain and underlying cause such as iron, folate or Vit B12 deficiency. Treatment choice should be guided by the severity of pain. Refer to Nice Guidelines [March 2021] here Assess daily for changes. End of life careAll aspects of mouth care that will provide comfort and improve quality of life should be included in the patient’s care plan (for example, pain relief, management of dry mouth, removing dry secretions, frequency of mouth rinsing). The focus is on oral hygiene, alleviation of symptoms and ensuring the patient is appropriately hydrated, it is recommended that the management of dry mouth is included in the patient’s care plan. For the conscious pt Consider changing or stopping meds that cause dry mouth. The mouth can be moistened every 30 minutes with water from a spray or dropper or ice chips placed in the mouth. For the unconscious pt Moisten the mouth at least every 1 hr with water from a spray, dropper or ice chips.
Oral pain Treat underlying cause of pain if possible, if not treat pain symptomatically. Use of topical non- opioid analgesics such as Benzydamine spray/mouthwash, Lidocaine 5% ointment or 10% spray For severe pain seek advice if pain is difficult to manage. Mouthwash
Other aspects of mouth care: training, dental access, and products, tools and support for patientsHealth and care professionals involved in the day-to-day care of patients should be trained and have access to training to deliver appropriate mouth care for palliative patients. There is currently very limited training available for staff and health and care professionals may not prioritise mouth care as part of palliative care. Training should contribute to improved mouth care and consistent advice. When to refer to a specialist1. If in doubt about the diagnosis, management or any oral problems2. Mouth problems are causing a decreased intake of food - concerns about malnutrition3. Severe herpes simplex infection4. Severe mucositis - can be extremely painful5. Suspect Neutropenic ulcer6. Aphthous ulcers are bleeding7. Severe persistent candida infection8. Disturbed taste (prolonged)9. Pain that is difficult to manage10. Communication problems (Speech and language therapist)For more information on palliative mouthcare management see links below [1] NICE (March 2021) NICE Clinical Knowledge Summary: Palliative care – oral [Online] Available at: https://cks.nice.org.uk/palliative-care-oral [2] NHS Scotland (revised Dec 2020). Scottish Palliative Care Guidelines – Mouth Care. [Online] here NHS Scotland Caring for Smiles 'Oral Care at the End of Life' PDF here [3] Public Health England, Oral health toolkit for adults in care homes [Nov 2020] Section 5 - How to support residents with mouth care part 2 [27/11/20] Palliative and end of life care presentation here What is used in mouth care of an unconscious patient?If the patient's mouth becomes dry, you can moisten it to keep them comfortable. If the patient is conscious, moisten their mouth every 30 minutes with water from a spray or dropper, or by placing ice chips in their mouth. If the patient is unconscious, use a spray, dropper or ice chips every hour.
Why oral care must be carried out for an unconscious patient?An unconscious patient requires frequent and meticulous oral hygiene to prevent oral health problems from developing. Because these patients usually breathe through their mouth and are unable to take in anything by mouth, sordes can easily accumulate on the lips, teeth, and tongue causing additional health concerns.
When providing oral care for an unconscious resident the CNA should?What's the process of oral care for an unconscious patient?. Gather supplies.. Check identification bracelet or name tag.. Introduce self, tell patient what you are going to do, provide privacy.. Wash hands, put on gloves.. Raise bed to comfortable height to perform oral care and raise head of bed 30 degrees.. |
