Mouth care for a person who is unconscious

Authors: V.Rednenko 

Editor: V.Rednenko 

Equipment for the practical skill:

• Simulated patient (patient manikin)
• Hospital bed with bedding
• Over-bed table
• Two towels
• Gloves
• Gauze squares
• Tongue depressor
• Tape
• Paper towels
• Cup
• Disposable mouth sponges
• Toothbrush
• Mouthwash
• Lip balm or petroleum jelly and cotton-tipped applicator

Clinical situation:

Patient N. is in the neurological department with acute cerebrovascular accident, he is assigned to the mouth care for a person. The patient is unconscious.  Carry out the prescribed procedure.

Order of the skill performance:

Preparatory stage:

• Identify patient
• Make sure you have the necessary equipment and put it on the over-bed table (the chair next to the bed)
• Sanitize your hands, put on gloves
• Prepare the patient bed:
• Raise the bed to a comfortable working height.
• Make sure the wheels on the bed are locked

Main stage:

• Cover the over-bed table with the paper towels and arrange your supplies. In the cup, prepare a solution of half water and half mouthwash.
• Position the person in high Fowler's position. Turn the person’s head toward you.
• Unfold one towel. Place it across the person’s chest. Place the other towel under the person’s head.
• Put on the gloves.
• Place the emesis basin on the towel near the person’s cheek.
• Pad the tongue depressor by wrapping the end in gauze and securing the gauze with tape.
• Without using force, gently separate the person’s upper and lower teeth. To do this, cross the middle fi nger and thumb of one hand. Put the thumb against the person’s top teeth and the middle finger against her lower teeth and gently push the fi nger and thumb apart to open the jaw.

• Insert the padded tongue depressor between the upper and lower teeth at the back of the mouth to hold the person’s mouth open.

• Clean the roof of the mouth, the inside of the cheeks, the gums, under the tongue, and the lips with mouth sponges dipped in the mouthwash mixture. Wrap a gauze square around your finger or use a mouth sponge to remove thick mucus or secretions.
• Use a toothbrush moistened with diluted mouthwash to clean the person’s teeth.
• Apply lip balm or petroleum jelly to the person’s lips.
• Remove and dispose of your gloves.

Final stage:

• Ensure the person’s comfort and good body alignment.
• Adjust equipment for safety: Lower the bed to the level specified in the person’s care plan. Make sure the wheels on the bed are locked. Place the person’s method of calling for help within reach. Lower or raise the side rails according to the person’s care plan.
• Clean up your work area.
• Wash your hands.