Saturday 21 July 2018

Some Essential Concepts 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.

Sometimes, the nasogastric tube may fail to be inserted correctly. This could be because the care giver lacks skills in correct placement. It could also be because the patient is not willing to have the tube inserted. Regardless of the reason, the healthcare team should find a good alternative to prevent the patient from starving. An intravenous infusion can be set up through which parenteral feeds can be administered.

One of the medical conditions that may require placement of a nasogastric tube is stroke which typically occurs among the elderly. Those with heart disease, high blood pressure and diabetes are at a high risk of getting a stroke. In persons affected by stroke, certain muscles suddenly become paralyzed. Doctors need to do a swallow test for patients presenting with stroke in order to adjust their feeding in the event that their swallowing is compromised.

It is important to prop up vulnerable patients and ensure that they lie on their side. Lying on a flat surface and facing upwards increase the chances of regurgitating food and diverting it into the respiratory tract. One can improvise accordingly if there are no actual pillows available.

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.




About the Author:



No comments:

Post a Comment