Basic Principles Regarding Aspiration Pneumonia Prevention

By Martha Wilson


Aspiration usually occurs as a result of lack of control of muscles in the upper gastrointestinal system. Inability to control food propulsion and swallowing may result in some of the digested food material getting into the respiratory tract. When this happens, the affected individual may suffer from what is termed aspiration pneumonia. It is, therefore, prudent to observe aspiration pneumonia prevention measures particularly for high risk groups. Some of these high risk groups include the aged, those with neuromuscular diseases, surgical patients and those who spend a long time in the intensive care unit.

Among the key ways to prevent the condition is to insert a nasogastric tube for patients who experience difficulties swallowing food because of paralysis of their muscles. It is important to put such patients under sedation so that the procedure can be done smoothly without agitating them. This conduit runs from the nostril to the pit of the stomach.

The caregiver should be careful not to clog the tube by limiting the foods to semi solids and liquids. The feeds need to be given after they have cooled down so that the stomach lining does not get corroded. Some of the common feeds administered include tea, milk and porridge. Also, the conduit needs to be replaced frequently with a clean one to reduce the risk of getting new infections.

In the event that an tube cannot be inserted even after several attempts, an alternative should be sought. Nutrients can reach the body through an infusion that runs via an intravenous system. Placement of a tube or setting up parenteral nutrition should only be used once it has been ascertained that the individual cannot tolerate any oral feeds.

Patients with stroke may often require insertion of nasogastric tubes due to the fact they present with paralysis of muscles, including those involved in swallowing. Among the first steps in the care of such patients is to confirm whether they can comfortably take in any feeds without choking. Some of the risk factors for stroke include diabetes, high blood pressure and conditions involving the heart.

There are a number of simple measures to observe when taking care of patients susceptible to aspiration so as to minimize the risk. One of them is to ensure that they sleep comfortably over a pillow such that they assume a propped up position. If there are no pillows available, the head of the bed can be elevated. In addition, the caregiver should ensure the patient lies on the side.

Patients being nursed in intensive care units over a long period of time are also likely to aspirate. Apart from propping them up and feeding them through a nasogastric tube, intubation also helps to separate the trachea from the food pipe. Those with chronic conditions also need to be monitored closely for any complications that may arise. This includes doing imaging studies of the lungs to detect any abnormalities.

In summary, aspiration pneumonia comes about when digested food goes into the respiratory tract instead of down the esophagus to the stomach. The elderly and those with disorders of nerves and muscles are the most likely to aspirate. Prevention involves assisted feeding and propping up.




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