Lynsey came in response to hearing of Rachael's choking episode. She read the medical notes relating what had happened. Lynsey then discussed the possible options to help Rachael thin her saliva. She explained about nebulisers, cough assisst machine, suction machine and medication to thin Rachael's saliva. She then discussed District Nurses as they usually distrubute the machines. Rachael asked if she could get a machine from her GP. Lynsey said a GP could do an assessment but stressed that the Distict Nurses issue out the Nebulisers/Cough Assist/Suction machines. Rachael asked if there was anyway she could get some mediation between herself and the District Nurses. Lynsey said she would look into it and said that a Practice Nurse/GP may be happy to do this. Lynsey then asked Rachael how she was managing to eat/drink Rachael said she sometimes struggles to swallow and take medication. Lynsey advsed to crush drugs and flush them through the rig. Rachael said she was worried about not getting the full dose that way, so Lynsey confirmed that she would get written confirmation from the doctor that taking drugs via a flush is ok. The discussion then returned to the benefits of using medication and machines to reduce saliva thickness.
Suction Machine: will remove sticky saliva from the top of throat
Cough Assist: will remove saliva and phlegm from the lungs
Nebulisers: actively thins saliva using water
Mucodyne: actively thins saliva using medication
Lynsey told Rachael to keep hydrated uing flushes as Rachael said she was down from 4 x 400ml drinks to 1 x 400ml a day. Lynsey said part of the reason Rachael's saliva was sticky was because she is taking less fluid via the mouth. Rachael said she was not taking any thickened fluids. Lynsey advised to try brushing Rachael's throat if saliva collects again. Rachael said the secretions are too low down for that to be of any use. Lynsey brought up training issues and said she would lok into what was on offer in way of staff training. Rachael then discussed her MyTobii. She mentioned it kept crashing and Lynsey said to speak to Smartbox about it.