11. Aspiration

Question 1

Aspiration is __

Answer 1

the inhalation of toxic substances into the lung, with an injury to the lung that is the result of the chemical, mechanical, and/or bacterial characteristics of the aspirate.

-Oropharyngeal is most common!
-May or may not involve an infection
-May be acute or chronic: micro or massive
-Table 4-15 shows management techniques

Question 2

Emergent management of Witnessed Aspirations:

Answer 2

Place pt in slight trendelenburg and turned to the right side to aid drainage.

Suction mouth and pharyngeal areas

bronchoscopy for large particles

Question 3

Emergent management of All Aspirations:

Answer 3

-O2, titrate up as needed
-Intubation/mechanical ventilation as needed
-Monitor for the onset of noncardiogenic pulmonary edema (ARDS) or. pneumonia
-Monitor for dropping/low BP

Question 4

**Due to the anatomy of the Right Mainstem Bronchus (__)___

Answer 4

(shorter, wider, and with less of an angle), most aspirations occur in the RIGHT lung. Although aspirations may occur in both lungs, they seldom are isolated solely to the left lung

Question 5

Etiology of Aspirations:

Answer 5

-Altered level of consciousness
-Drug or alcohol abuse
-Depressed gag, cough, or swallowing reflexes
-Presence of feeding tube (all types)
-Improper pt positioning
-Presence of artificial airways
-Ileus or gastric distension
-History of dysphagia, GERD, esophageal strictures, decreased GI motility
-Increased secretions

Question 6

Signs and Symptoms of Aspirations

Answer 6

-Acute respiratory distress
-Presence of gastric contents in oropharynx
-Tachycardia
-Hypoxemia
-Crackles
-Copious secretions due to alveolar edema
-Hypotension (massive fluid shifts may occur)