Mouth Taping--Consequences?

[birdshell]

The subject of mouth taping keeps being reported on this forum as a practice to be avoided. The folks recommending this avoidance are usually RT's or sleep docs.

Please, please, anyone with a DOCUMENTED case of a complication (I'm not even specifying death--just a complication) due to mouth taping, please post it on this thread.

Here is a quote from another thread that outlines MY feelings on the subject.

I mentioned mouth taping to my doc, and he asked me how I was doing it. After explaining, he said to try making my own chin strap, but didn't say, "DON'T TAPE!!! YOU COULD PUT YOUR EYE OUT, OR CHOKE ON YOUR OWN VOMIT AND DIE!!!!" In fact, he said NOTHING negative about taping, unless I was supposed to take his re-direction as a "no".

This is one of those things that strikes me as being without documentation. If ANY of our professionals who monitor this forum can tell us of ANY documented case of death from mouth taping due to aspiration of vomit--I would love to hear it.

As far as coughing, I do so with tape on my mouth. Sometimes I manage to channel air through the sides of my mouth. I tape only the center, so there is a bit of space on the sides. Sometimes, I cough and open my lips, but the tape is still adhered to my skin and the air escapes through the sides.

Other times, I take off the tape for a good cough and stick it back on--or may have to replace it. If I have smeared the milk of magnesia on my skin (and allowed to dry before applying tape), there is a better chance of the tape re-sticking.

Concerning aspirating vomitus, I am physically unable to vomit after a Nissen fundiplication. I'd just LOVE for a medical professional to tell me about death by aspiration, cuz I have the perfect answer.

Should one be impaired enough to be unaware of vomiting, DON'T TAPE! If we tell folks to avoid driving when drinking, surely they can avoid taping. Besides, if one is that impaired, would one even THINK of using the xPAP OR taping one's mouth? Really, c'mon.

PLEASE, please medical professionals. Is there an instance of a sentient being choking from mouth taping? And please--don't put out an eye in order to answer.

[NyNurse33]

I can't help by giving you a documented case of a complication, I just can state that I see why some health professionals might be worried about. But I'm not saying that I agree or disagree. I've never taken care of anyone using cpap and especially a patient with their mouth taped. I can only speak from experience when it comes to someone who is wearing an o2 mask and not alert enough or physically able to take it off when they vomit. We always had to react quickly when it came to that b/c of aspiration pneumonia.

[birdshell]

I certainly understand that situation, and appreciate very much your input. You are definitely my kind of nurse, and I realize that this isn't your specialty. I AM sure that it will be a specialty of yours (if not officially, then for your own satisfaction) very soon.

But, as we keep having sleep techs and RT's and sleep docs telling our Forum Folk that they could die from aspiration, etc. that I'd like to see the scientific proof. After all, these medical professionals ARE supposed to be basing our treatment on scientific studies.

I'm not even looking for solid statistical proof: I'd be willing to settle for anecdotal evidence. (But, if you happen to have solid statistical proof, I'll gladly look at it.)

It is just that we lay folks cannot search many of the medical journals and information sites. Maybe someone who knows a medical librarian would ask for some research ONLY if said librarian is willing, and not too busy.

Let us just get to the factual bottom of this. Hey, if it doesn't make Snopes, it is still good for all of us to know!

[Vader]

Good idea for a separate thread on this question.

As I said on the other thread, personally, I don't need to mouth tape, but I would like to know a definitive answer on this.

[Snoredog]

Health professionals are worried about it because they have malpractice insurance, if they told you to tape your mouth and you poked out your eye they would be liable and their insurance rates would go up or be dropped.

[cwsanfor]

It is just that we lay folks cannot search many of the medical journals and information sites. Maybe someone who knows a medical librarian would ask for some research ONLY if said librarian is willing, and not too busy.

I'm not a medical professional, Global Disclaimer here, but I do have access to a good number of online medical, scholarly, and general academic resources through the university where I work. Although you can find plenty on the dangers of vomitus aspiration in severly dysfunctional patients, and my memory includes the aspiration-related deaths of several rock stars back in the day, I have not as yet seen documentation of aspiration-related excess morbidity in xPAP users. Maybe it could happen, maybe you could get hit by a bus.

From an anecdotal position, it just seems to me that you'd have to be mighty drunk or something to vomit in a mask (edit: or a taped mouth) and not know it. So impaired that you could not likely be able to put the mask on by yourself, which would imply a managed care scenario, like being in a hospital. It just seems like a low-probability/high-risk scenario, but then again, they're the hardest risks to assess.

Still, if I was in a coma, or chose to chase a handful of barbituates with a bunch of whisky, I'd probably not prefer to be taped or using a full face mask. But that's just me. Of course I don't tape anyway, because I use a FF mask. I did tape and use Polident strips, and tried a chin strap, unsucessfully, when I did use a nasal interface.

<donning asbestos suit>

CW "Has Never Once Vomited in His Sleep" Sanfor

[CollegeGirl]

That is my thought - what difference is there between mouth-taping and a full-face mask, in that regard? Yes, a FFM has vents to allow for air to escape in case of the machine being off, but one wouldn't be getting any air in OR out if they vomited into the mask - the nose and mouth would both be covered (eww...I know). So I don't see how taping is different from wearing a full face mask in that specific circumstance.

I can see how it's different in relation to breathing - what if, for some reason, you were asleep and not realizing you weren't getting adequate air through your nose? You couldn't open your mouth slightly to take in air that way in an emergency. But I would imagine that if that would occuring it would wake you up anyway. I could be wrong.

[cwsanfor]

Wait a minute, "put out your eye"? Was this a serious statement? What up dat?

[christinequilts]

It almost seems like they make a bigger deal out of the potential dangers of mouth taping then anything my doctors conveyed to me when my mouth was wired shut for 8 weeks after having my lower jaw lengthed (due to severe TMJ & severe malalignment). Now this was (gulp!) 17 years ago, but I can tell you that was a lot more risky. I never vomited at night, while sleeping, and I can't remember ever having done so in my entire life.

I am a non-taper, I'm one of those lucky people who can't get air to come out through my mouth no matter what I do while on xPAP and have been like that from day one, so my take on this is purely observational. It almost seems as if some of the mouth pieces & headgear you have to wear when you have braces could potentially be more dangerous, especially when you consider the age most people have orthodonic work, IMHO.

[birdshell]

"Put your eye out" was just a silly statement used to (hopefully) demonstrate the improbability of consequences to the whole mouth taping issue.

The idea was/is: putting out one's eye is just as ridiculous as a consequence of mouth taping as is aspiration, pneumonia from aspiration, and inability to cough....

And, CG, if one leaves a little space in the corners, and leaves enough room for the lips to remain "normal" (as opposed to tingling from the pressure of being pressed together too tightly)--I think that rescue breathing could be a strong possiblity. I'll try it tonight.

If you haven't seen the old movie, "A Christmas Story," with Darrin McGavin and Peter Billingsley as a child--it is worth a look. (I think it has become a Christmas time classic.) If you do you will better understand the phrase, "You'll put your eye out!!!!"

[CollegeGirl]

If I leave any "space" at all, air leaks out. As it is, if I don't press my lips together tightly enough before applying tape, and if I don't get the tape centered just right, drool gets to the tape and unsticks it in the middle of the night.

[birdshell]

Bummer, CG. I have been a drooler, but now think it was due to the apneas. It used to seem to happen especially when I was hot (as in b/a/c, which is before air conditioning). I used to joke that I was panting because I was so hot.

But I feel for you, because I started with the entire mouth and then slowly started to leave more and more space at the edges. I'd gotten down to a single vertical piece of 1" wide tape, but then seemed to be taking it off unknowingly. So I went back to 2-1" pieces of vertical tape. So far, so good.

The only time I had it open up on me is when I tried some 3/4" wide tape, as that was all I could find. This may have been my first night, in fact. I had used 3 strips horizontally, and managed to pull them apart and open in the night with my lips.

Now that we all have WAY too much info about my lip taping adventures, I'll sign off. Hang in there, CG and remember that we have no ACTUAL case studies of complications from full mouth taping as of tonight.

Off to seal my lips!

[cwsanfor]

I really love this group. Drooling, taping, jaw relocation, vomiting into our masks, remedies for sores on our noses, strap mark accessories, and we're all like "Well, that's like you do."

[oldgearhead]

..or maybe they aren't talking?...

[birdshell]

With nurses in my family, not to mention phys. ed. teachers and an elementary level teacher, Thanksgiving dinner is always interesting. If anyone rom outside the family comes, they had better NOT have a weak stomach.