Oral Care during Intubation
A patient placed on mechanical ventilation with an endotracheal tube
must have mandatory scheduled oral care to maintain proper
hygiene and oral health.
Brushing the teeth, gums, and tongue with chlorohexidine cuts down on
growing bacteria cultures and biofilm in the oral cavity. Oral care along
with proper endotracheal cuff and tube management can help prevent
reparatory infections like VAP Ventilator Associated Pneumonia, and
also alert healthcare professions to dental problems like periodontal disease.
In most facilities, the respiratory therapist
and nursing staff are responsible for
sharing the following tasks:
Moving the ET tube periodically to prevent pressure sores on the lips
Oral care of the mouth and ET tube
ET Cuff management for proper inflation (20 to 25 mm hg/ 25 to 30 cm H20)
Suctioning above and below the ET cuff to prevent issues
Keeping the head of the bed at above 30 degrees
Oral care that is not properly managed can also lead to
more serious issues than developing VAP.
Patients with excessive tooth decay
or loose teeth are at a real risk of aspirating teeth.
A dental consultation should be warranted if the
clinician identifies problems during assessment.
Mechanical Lung ventilation in intensive care unit