Comparison between Effect of Using Cold Water Oral Swap and Cold Saline Oral Swab to Relieve Thirst Intensity and Oral Condition of Mechanically Ventilated Patient

Intessar Mohamed Ahmad^1,

¹Critical Care Nursing Department, Faculty of Nursing, Damanhour University, Egypt

Cite this paper:
Intessar Mohamed Ahmad. Comparison between Effect of Using Cold Water Oral Swap and Cold Saline Oral Swab to Relieve Thirst Intensity and Oral Condition of Mechanically Ventilated Patient. American Journal of Nursing Research. 2019; 7(1):8-13. doi: 10.12691/ajnr-7-1-2

Abstract

Introduction: Thirst can be defined as a longing or desire to drink water, not necessarily generated by a physiological need, but also triggered by habit, taste, dry mouth or throat and the willing to consume fluids that provide a sensation of heating or cooling. In intensive care units, patients face conditions that predispose them to develop the symptom thirst. Like pain, thirst must be detected before it can be treated. Aim of the study: The aim of the study was to compare between effect of using cold water oral swap and cold saline oral swab to relieve thirst intensity and oral condition among mechanically ventilated patient. Material and method: Research design: A quasi – experimental design was utilized to study the effect of using oral swap with cold water and oral swab with cold saline on thirst relief and oral condition. Setting: This study was conducted at the general ICU of Damanhour Medical Institute having 15 beds. Sample: convenient sample of 60 mechanically ventilated patients were recruited in the current. Instrument: an assessment sheet was used to collect data including the following three tools: 1- Demographic and biomedical data tool which includes age, gender and variables relevant to disease as patient's diagnosis, date of admission, length of stay and days mechanically ventilated on the study. 2- Thirst intensity scale: it is a visual analogue scale (VAS) rates intensity of thirst on a 10-cm with 0 indicating no thirst at all, and 10 indicating the worst possible thirst. The VAS scores were classified into: mild (0-3), moderate (4-6) and severe (7-10). In addition, it includes the presence of thirst (yes/No). 3- Oral condition assessment tool: it measures change of oral condition including lips, mucosa, tongue and saliva. It includes items which scored on a 3- point scale from 1to 3. Lip has 1 if it is smooth, pink and moist, 2 if it is dry or cracked and 3 if it is ulcerated. As regards tongue has 1 if it is pink and papillae present 2 if it has loss of papillae and 3 if it is blistered or cracked. In relation to mucosa has 1 if it is pink & moist, 2 if it is red or white coated 3 if it is ulcerated with or without bleeding. Regarding saliva has 1 if it is watery, 2 if it is thick and 3 if it is absent.

Keywords:
cold water cold saline oral swap thirst mechanically ventilated patients

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References:

[1]	Arai S, Stotts N, Puntillo K. Thirst in critically ill patients: from physiology to sensation. Am J Crit Care. 2013; 22(4):328-35. Availablefrom: https://www.ncbi.nlm.nih.gov.
[2]	Leiper J. Thirst. In: Caballero B, Allen L, Prentice A. Encyclopedia of human nutrition. 2nd ed., UK: Elsevier Academic Press, 2005. P. 278-86.
[3]	Perlas A, Davis L, Khan M, Mitsakakis N, Chan VW. Gastric sonography in the fasted surgical patient: a prospective descriptive study. Anesth Analg. 2011; 113(1): 93-7.
[4]	De Vecchis R, Baldi C, Cioppa C, Giasi A, Fusco A. Effects of limiting fluid intake on clinical and laboratory outcomes in patients with heart failure: results of a meta-analysis of randomized controlled trials. Herz. 2016; 41(1): 63-75.
[5]	Landstrom M, Rehn IM, Frisman GH. Perceptions of registered and enrolled nurses on thirst in mechanically ventilated adult patients in intensive care units– a phenomenographic study. Intensive Crit Care Nurs. 2009; 25(3): 133-9.
[6]	Puntillo KA, Arai SR, Cooper BA, Stotts NA, Nelson JE. A randomized clinical trial of an intervention to relieve thirst and dry mouth in intensive care unit patients. Intensive Care Med. 2014; 40(9): 1295-302.
[7]	Lombardo V, Vinatier I, Baillot ML, Franja V, Bourgeon-Ghittori I, Dray S, Jeune S, Mossadegh C, Reignier J, Souweine B, Roch A. How caregivers view patient comfort and what they do to improve it: a French survey. Ann Inten Care. 2013; 3: 1-8.
[8]	Rose, L.; Nonoyama, M.; Rezaie, S.; Fraser, I. Psychological wellbeing, health related quality of life and memories of intensive care and a specialised weaning centre reported by survivors of prolonged mechanical ventilation. Intensive Crit Care Nurs. 2013.
[9]	Persenius MW, Hall-Lord ML, Wilde-Larsson B. Grasping the nutritional situation: a grounded theory study of patients’ experiences in intensive care. Nurs Crit Care. 2009; 14:166-74.
[10]	Nelson JE, Meier DE, Oei EJ, et al. Self-reported symptom experience of critically ill cancer patients receiving intensive care. Crit Care Med. 2001; 29: 277-282.
[11]	Nelson JE, Meier DE, Litke A, Natale DA, Siegel RE, Morrison RS. The symptom burden of chronic critical illness. Crit Care Med. 2004; 32: 1527-1534.
[12]	Morita T, Tei Y, Tsunoda J, Inoue S, Chihara S. Determinants of the sensation of thirst in terminally ill cancer patients. Support Care Cancer. 2001; 9(3): 177-186.
[13]	Aroni P, Nascimento LA, Fonseca LF. Assessment strategies for the management of thirst in the post-anesthetic recovery room. Acta Paul Enferm [Internet]. 2012; 25(4): 530-6.
[14]	Conchon MF, Nascimento LA, Fonseca LF, Aroni P. Perioperative thirst: an analysis from the perspective of the Symptom Management Theory. Rev Escola Enferm USP. 2015[cited 2016; 49(1): 120-8.
[15]	Campana MC, Fonseca LF, Lopes DFM, Martins PR. Percepcao dos cuidadores quanto a sede da crianca cirurgica. Rev Rene. 2015; 16(6): 799-808.
[16]	So HM, Chan DS. Perception of stressors by patients and nurses of critical care units in Hong Kong. Intern J of Nurs Studies. 2004; 41: 77-84.
[17]	Prendergast V, Jakobsson U, Renvert S, Hallberg IR. Effects of a standard versus comprehensive oral care protocol among intubated neuroscience ICU patients: results of a randomized controlled trial. J Neurosci Nurs. 2012; 44(3): 134-46.
[18]	Yoon SY, Min HS. The effects of cold water gargling on thirst, oral cavity condition, and sore throat in orthopedics surgery patients. Korean J Rehabil Nurs. 2011; 14(2): 136-44.
[19]	Cho E.A, Kim K.H, & Park J.Y. Effects of frozen gauze with normal saline and ice on thirst and oral condition of laparoscopic cholecystectomy patients: Pilot study. Journal of Korean Academy of Nursing. 2010; 40 (5): 714-723.
[20]	Moon YH, Lee YH, Jeong IS. A comparison of effect between wet gauze with cold normal saline and wet gauze with cold water on postoperative thirst, oral cavitycondition, and saliva pH. J Korean Acad Fundam Nurs. 2015; 22(4): 398-405.
[21]	Hur Y.S, Shin K.A, Lee WJ, Lee J.O, Im H.J, Kim Y.M. The comparison of moisturizing effect of cold water gargling, wet gauze application and humidification in reducing thirst and mouth dryness after nasal surgery. Journal of Korean Clinical Nursing Research. 2009; 15 (1): 43-53.
[22]	Arai S., Stotts N, Puntillo K. Thirst in critically ill patients: from physiology to sensation. American Journal Critical Care. 2013. Available from : http://www.ncbi.nih.gov.
[23]	Seo-Young, Y., & Hye-Sook, M. The Effects of Cold Water Gargling on Thirst, Oral Cavity Condition, and Sore Throat in Orthopedics Surgery Patients. Korean Journal Rehabilitation Nursing. 2011; 14 (2), 136-144.
[24]	Park, J., McGuire, D. B. & Kang, H. The effects of mouth care with cold sterile normal saline (CSNS) in head and neck cancer (HNC) patients undergoing Concurrent Chemo-radiotherapy (CCRT). Supportive Care in Cancer. 2012; 20. S246-247.