manual disimpaction

2 so...tonight i had a patient who was an obligate nose breather with 2L O2 per NC. i noticed he was tachypneic, and somewhat labored, so i contacted the RT to see if she thought his breathing was becoming worse. after her assessment, she told me that he seemed dry, nasally, and when she inspected his nares, she noted a large, dry booger that was most likely obstructing his right nare. so i grabbed my penlight, flushes, swabs, and tweezers and had a nauseating time trying to remove this obstruction.
anyone have any experience with this? what to do?!?! oh yeah, this guy was nonverbal, immobile/contracted, so i was trying to do him a favor....i would want my nose picked too
Seriously u made me laugh ahaha...no never had to pick a booger hahaha

i'd rather disimpact a nose than the rear-end!

ditto what they said

Could be worse, could be a manual disimpaction of the other end...

Quote from simbokaCould be worse, could be a manual disimpaction of the other end...

HAHA! This was a good laugh to wake me up!! I am with you on the booger thing...I can clean up poop all day, but something about mucus makes me queasy! Ahhhhh...the joys of nursing...but I'd rather do this than go back to sitting at a sales desk!!

Sorry, it made me laugh too! Also it got me thinking, is there a medical term for BOOGER? (I'm just starting nursing school!)

That's too funny! Next time, get one of the big, sterile q-tips and some steri-lube instead of trying to remove the dried up and no doubt stuck to the long nose hair snot! I'd still rather pick the nose!

Quote from kathy313That's too funny! Next time, get one of the big, sterile q-tips and some steri-lube instead of trying to remove the dried up and no doubt stuck to the long nose hair snot! I'd still rather pick the nose!

Speaking of de-boogering unresponsive patients, I recently had a patient on comfort care who had a large amount of mucous in his throat. You could see it bubbling in the back of his mouth, thick and green. Although he had been unresponsive for a couple days, he was clearly in distress, reaching for me and looking frantically about the room, tachypnic, hypertensive, etc. The family asked if I could help him, without even pondering it too much I NT suctioned him. It was by far the most gratifying suctioning I had ever experienced, capped off with a mucous plug the size of a penlight.It was only after that I wondered if what I did was appropriate. At the time it seemed obvious, but the responses from nurses varied widely. Some chastized me for not allowing natural death, others agreed that wasn't really a humane way to allow a patient to die, choking on their own mucous while children and grandchildren watched.Any thoughts?

Definately suction...wouldn't you think that would be under comfort cares? That's what I would do, even though that is the only thing that really gives me the willies.

In my opinion, you did the right thing. Could you imagine if the nurse responded to you, as you watched your love one choking to death on their own mucus, "oh, we just have to let him go naturally..." Yuck. What kind of nurse would allow someone to go that way.