口腔护理

Oral Care

苏奶奶，帕金森病，卧床，生活不能自理，不会刷牙漱口，请健康照护师用棉棒法为苏奶奶进行口腔清洁.

Grandma Su is bedridden due to Parkinson's disease, which renders her unable to care for herself, including brushing her teeth or gargling. A health care provider has been requested to assist in cleaning Grandma Su's mouth using cotton swabs.

步骤1：工作准备

Step 1: Preparation

1、环境准备：干净整洁，温湿度适宜

1. Environment preparedness: maintain a clean and well-organized environment; ensure the temperature and humidity are comfortable and suitable.

2、照护人员准备：着装整齐；七步洗手法洗净双手、戴?罩。

2. Caregiver preparedness: dress up neatly; clean hands thoroughly using the seven-step hand-washing method, wear a face mask.

3、照护对象准备：平卧在床，评估全身状况尚好、无义齿、无口腔溃疡无牙龈出血，可以操作。

3. Care recipient preparedness: ensure the elder is lying flat in bed and in good condition before proceeding with mouth cleaning; make sure they have no dentures, oral ulcers, or gingival bleeding.

4、物品准备：治疗车，治疗盘1个，弯盘1个，治疗碗1个，污物碗1个，大棉棒18-20个，压舌板1支，手电筒1支，润唇青1支，?杯(盛温开水)，干毛巾1条。

4. Items preparedness: a treatment vehicle, a treatment plate, a curved plate, a treatment bowl, a dirt bowl, 18-20 large cotton swabs, a tongue depressor, a flashlight, a lip moisturizer, a cup (filled with warm boiled water), and a dry towel.

步骤2：沟通

Step 2: Communication

5、推治疗车放在床头，向照护对象解释，取得配合

5. Move the treatment vehicle to the bedside; encourage the patient to cooperate with the care process

步骤3：摆放体位

Step 3: Take a body position

6、协助照护对象头偏向一侧，面向照护人员，毛巾铺在老年人胸前及右侧颌下枕头上，取弯盘置于老年人右侧颔下。

6. Assist the care recipient in tilting their head to one side and make them face the caregiver; place a towel on their chest and a pillow under their right jaw; position the curved plate under their right jaw.

7、清点治疗碗内棉棒18-20个，用温水将棉棒浸湿，以推压杯壁不渗水为宜。

7. Retrieve 18-20 cotton swabs from the treatment bowl and immerse them in warm water; ensure that there is no leakage of water when a cotton swab is pressed against the cup wall.

步骤4：检查口腔

Step 4: Oral examination

8、用棉棒温润口唇，嘱照护对象张口，照护人员左手持压舌板，右手特手电筒检查口腔粘膜有无出血，有无感染；昏迷者或牙关紧闭者可用开口器协助张口。

8. Moisten the patient's lips with a cotton swab; instruct them to open their mouth; hold the tongue depressor in the left hand and the flashlight in the right hand to check for any signs of bleeding or infection in the oral mucosa; if the patient is unconscious or clenching their teeth, use a mouth gag to keep the mouth open.

步骤5：清洁口腔

Step 5: Oral cavity cleaning

9、协助清醒的照护对象用吸管吸水漱口，将漱口水吐入弯盘内，擦净口唇。

9. Assist the awake care recipient in drinking water through a straw and rinsing their mouth; ask them to spit the mouthwash into the curved plate and then wipe their lips clean.

10、按“一外、二内、三交合、四腭、五舌、六双颊”顺序进行擦拭，每擦一个部位换一个棉棒。将照护对象口腔分为四个象限，即左上、左下、右上、右下。

10. Clean the patient's mouth in the following sequence: outer area, inner area, occlusal surface, palate, tongue, and cheeks, using a fresh cotton swab for each step. The oral cavity of the care recipient is divided into four quadrants: upper left, lower left, upper right and lower right.

11、外：嘱照护对象咬合上下齿，用压舌板轻轻撑开左侧颊部，纵向擦洗牙齿的外侧，由臼齿擦向门齿。按左上外-左下外-右上外-右下外顺序擦洗。

11. Outer area: instruct the care recipient to bite down on the upper and lower teeth; gently strut the left cheek with the tongue depressor; scrub the outer side of the teeth from the molars to the incisors in a longitudinal motion. Scrub the teeth in the following sequence: upper left outer side, lower left outer side, upper right outer side, lower right outer side.

12、内：嘱照护对象张开上下齿，纵向擦洗牙齿的外侧，由臼齿擦向门齿。按左上内-左下内-右上内-右下内顺序擦洗。    

12. Inner area: instruct the care recipient to show their upper and lower teeth; scrub the outer side of the teeth from the molars to the incisors in a longitudinal motion. Scrub the teeth in the following sequence: upper left inner side, lower left inner side, upper right inner  side, lower right inner side.

13、咬合：擦洗牙齿咬合面，按左上-左下-右上-右下顺序擦洗。

13. Occlusal surface: scrub the occlusal surface of teeth in the following sequence: upper left, lower left, upper right, lower right.

14、腭：由内向外擦洗左上腭、右上腭。

14. Palate: scrub the left palate and right palate, starting from the inside and moving towards the outside.

15、舌：由内向外擦洗舌背、舌腹。

15. Tongue: scrub the top and underside of the tongue; work your way from the inside to the outside in a sweeping motion.

16、双颊：由内向外弧形擦洗左颊、右颊。       

16. Cheeks: scrub the left cheek and the right cheek; work your way from the inside to the outside in a sweeping motion.

步骤6：整理用物

Step 6: Sort the items used

17、擦洗完毕后清点棉棒数量，擦洗前后数量相等。左手取压舌板，右手拿手电筒；再次检查牙龈无出血。

17. After scrubbing, count the cotton swabs to ensure that the number of them is the same as before the scrubbing. Hold the tongue depressor in the left hand and the flashlight in the right hand to check once more for any bleeding in the gums.

24、撤去弯盘放于治疗车下层；擦干?周及面部，撤掉放于治疗车下层。涂润唇膏；洗手，记录

24. Dry the perioral areas and the face, then remove the curved plate and place it on the lower floor of the treatment vehicle. Apply lip balm; wash hands; log the process

注意事项

Precautions

1、动作轻柔防止碰伤粘膜。意识不清照护对象禁漱口

1. Handle with care to avoid damaging the mucosa. It is not recommended to ask an unconscious care recipient to gargle

2、每面换棉球1个，不得重复使用

2. Use a fresh cotton ball for each side and avoid reusing the same one

3、棉球或棉棒不可过湿，防止多余水分引起照护对象呛咳

3. Ensure that cotton balls or swabs cannot be overly saturated with water; excess moisture can potentially lead to coughing in the individual receiving care

4、每次张?擦拭时间不可过长，以20-25秒为限

4. The duration for which the care recipient opens their mouth for cleaning should not be too long. Ideally, it should be limited to 20-25 seconds

5、擦拭上颚和舌面位置不可太深，避免照护对象不适。

5. Don't wipe the rear part of the upper jaw or tongue surface, this can cause discomfort to the care recipient