Pamela V O Neal

Pamela V O Neal

University of Alabama in Huntsville, USA

Title: Palliative Practices to promote airway clearance


Pamela V O'Neal, PhD, RN is Associate Professor of College of Nursing. She teaches the undergraduate and the doctor of nursing practice programs. She has a research focus in assessing suctioning processes to improve patient outcomes and is Co-Director of the Clear Project. She has experience in both laboratory and clinical research related to suctioning with newborns, adults, and older adults. She is Past-President of the North Alabama Chapter of the American Association of Critical Care Nurses, Chair of the Institutional Review Board for UAH, and was recognized as the Outstanding Faculty in the College of Nursing.


Palliative care addresses pain and suffering across the lifespan with any type of illness and is inclusive of all age groups. National Hospice and Palliative Care Organization (NHPCO) estimated as many as 1.5 million patients in 2013 received hospice services. The largest population of hospice services were mostly female (55%) and age 85+ (41%); however, 0.4% were less than 24 years, which indicates young adults, children, and infants. The top non-cancer diseases requiring palliative services were dementia (15%), heart disease (13%), and lung disease (10%), and all these diseases involve sequelae associated with dysphagia, dyspnea and respiratory compromise. Oral secretion accumulation and viscous secretions contribute to pulmonary distress. Oral secretions can migrate to the pharyngeal area and transit to the lower airways contributing to pneumonia. Oral secretion removal is critical; especially when someone at the end of life is no longer able to functionally manage their own secretions. The viscosity of oral secretions can influence secretion removal. Current research involves the design and fabrication of a microfluid viscometer to assess viscosity of oral secretions in order to effectively evacuate these secretions. Removal of viscous and non-viscous oral secretions promotes effective airway clearance, relieves deleterious effects of poor oxygenation, and provides comfort support though manual secretion removal with a soft-tipped suction device. The purpose of this presentation is to focus on integrating palliative care practices to assist children, adults, and older adults in promoting airway clearance, managing respiratory compromise, and providing supportive pulmonary care at the end of life.

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