What is aspiration How can the nursing assistant help prevent aspiration during oral care unconscious residents?

Importance of Oral Care in Nursing:

Oral care or mouth care is one of the most basic nursing activities. Keeping the mouth and teeth clean will protect a patient’s oral health and allow quicker recovery by preventing infections. The patient is unconscious, oral care will be needed more frequently. Unconscious patients usually breathe through the mouth, causing secretions to dry. It is a vital aspect of patient care that needs to be carried out consistently by a nurse. The nurse plays an important role in providing effective oral care and promoting oral hygiene of an unconscious patient. Nurses should be aware of risk factors associated with poor oral health and be able to assess and help patients maintain oral hygiene. In another article, I have shared an article about mouth care procedures for conscious patients. You may follow it.

Supplies and Equipment for Unconscious Patient:

A tray containing supplies and equipment  needed for oral care or mouth care are listed in the following:

1. Small mackintosh–1,
2. Towel—1,
3. Kidney tray-2,
4. Gauze piece or cotton balls,
5. Mouth wash solution (0.12% Chlorhexidine or 05% Cetylpyridinium Chloride),
6. Galipot-1(Denture soaking solution),
7. Gloves,
8. The aseptic syringe or irrigating bulb,
9. A suction catheter with a suction apparatus,
10. A cotton ball with artery forceps,
11. Gauze padded tongue depressor,
12. Mouth gag (if patients unconscious to open the mouth),
13. Plain water in a mug,
14. Paper bag.

Mouth Care Procedure for Unconscious Patient:

Oral care procedures are used for patients who are unconscious or who are not able to eat or drink.

1. Arrange all equipment on the bedside cabinet or an overbed table.
2. Set the patient’s bed in a comfortable position and lower one side rail.
3. Place a bulb syringe or suction machine with a suction machine nearby.
4. Place the client in a side-lying position and raise the level of the bed on one side so that the patient is in a partial sitting position.
5. Rinse your hands properly with antiseptic soap and lukewarm water.
6. Wear gloves after drying hands.
7. Place towel or waterproof pad under the client’s chin and Wrap the patient’s chest
8. Keep the kidney tray under the patient’s cheek or remove secretions from the mouth by the suction catheter.
9. Use a padded tongue blade to open teeth gently. Never put your fingers in an unconscious patient’s mouth.
10. Turn the head of the patient towards you in a very gentle manner.
11. A clean mouth, gums, teeth, and tongue with toothbrush and toothpaste.
12. Use an Asepto syringe or irrigating bulb without a needle to rinse the oral cavity. Swab or use oral suction to remove pooled secretions
13. Clean immediately after brushing and Suction the saliva and toothpaste from the mouth of the patient.
14. Wipe out the extra water on the mouth with a clean small towel.
15. Removes basin dries face and mouth, and applies water-soluble lip moisturizer.
16. Bring the patient back to a comfortable position.
17. Raise side rail and lower bed position.
18. Dispose of gloves in a paper bag and wash hands properly.
19. Report & documents oral findings and procedure.

Oral Care Instructions for Unconscious Patients:

Some important general instructions for ICU patients must be maintained during oral care or mouth care delivery:

1. Sit the patient fully upright to prevent aspiration during mouth cleaning.
2. Inspect the patient’s oral cavity (lips, gums, teeth, tongue, inside cheeks, and mucosa of floor and roof of the mouth) for any sign of dryness, edema, redness, bleeding, or other debris.
3. Choose the appropriate devices and cleaning products for oral cavities.
4. Use Yankauer suction to remove excessive secretions and loose debris.
5. Avoid oral care with Hydrogen Peroxide if oral thrush or oral lesions present.
6. Use toothpaste to brush the teeth and use an electric suction toothbrush to reduce the risk for aspiration of contaminated water.
7. If dentures present, remove and gently brush and rinse. Soak dentures overnight.
8. Gently brush teeth in circular motions at a 45-degree angle to the gum line.
9. Brush for 1-2 minutes to remove plaque build-up.
10. Use 0.05% Cetylpyridinium Chloride (anti-fungal and anti-bacterial) containing mouthwash to reduce the risk of infection and to remove plaque.

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Maria Katun Mona is a Nursing and Midwifery Expert. Currently she is working as a Registered Nurse at Evercare Hospital, Dhaka, Bangladesh. She has great passion in writing different articles on Nursing and Midwifery. Mail her at