Aspiration Flashcards
Adult risk factors for aspiration?
> 75yo, drug/alc intoxication, anesthesia, stroke, neurological disease
Clinical presentation of foreign body aspiration?
May only have chronic cough (if small, can persist for week/months), fever, chest pain, dyspnea/wheezing (less common), hoarseness, foul smelling sputum*
These possible sequelae may following objects left in place for a while?
recurrent pneumonia, atelectasis, bronchiectasis, lung abcess, pneumothorax, pneumomediastinum
If radiologic imaging is still uncertain, order these?
Laryngoscopy or bronchoscopy (treatment of choice)
Post removal treatment of foreign body?
Corticosteroid if tissue swelling occurs. Antibiotics if respiratory infection occurs
These patients are at risk for aspiration pneumonia?
Alcoholism, cig smoking, poor dentition, homeless, neuromuscular disease, mental status changes, chronic or sever esophageal reflux
These organisms cause bacterial aspiration pneumonia?
Oral anerobes. Peptostreptococcus, fusobacterium nucleatum, prevotella, and bacteroides spp
Clinical presentation of bacterial aspiration pneumonia?
Fever, cough, fatigue, dyspnea, purulent sputum, may progress slower than typical course of CAP or nosocomial pneumonia. *Chills and rigors uncommon
CXR findings of bacterial aspiration pneumonia?
Lung abscesses, necrosis that causes round lesions with airfluid level, empyema
Treatment for bacterial aspiration pneumonia?
Clindamycin 600mg IV q8h OR amoxicillin-clavulanic acid 875mg PO BID OR Metronidazole + Amoxicillin. 7-10 treatment if no abscess or empyema, may need longer if present
Clinical presentation of chemical pneumonitis?
Abrupt onset, severe and prominent dyspnea, low-grade fever, crackles, severe hypoxia
Treatment of chemical pneumonitis?
Suction airway to remove any tracheal fluids, support pulm. function with positive pressure ventilation or mechanical ventilation, antibiotics if secondary bacterial pneumonia suspected
