ASPIRATION
Aspiration is defined as the inhalation of food, fluid, saliva, medication or other foreign material into the trachea and/or lungs. This can occur during swallowing, choking, or if stomach contents are refluxed back into the throat. Although aspiration can occur with anyone, attentiveness to the following information will help identify risk factors, symptoms and interventions important to consider for persons we support.
Factors that place individuals at risk for aspiration:
- · Being fed by others
- · Inattention to the dining plan and/or feeding guidelines for an individual
- · Weak or absent coughing, and/or gag reflexes, commonly seen in persons with neurological dysfunction such as cerebral palsy and muscular dystrophy
- · The return of partially digested food or stomach contents to the esophagus/throat due to gastroesophageal reflux disease (GERD) which can result in aspiration of stomach contents
- · Food stuffing, rapid eating/drinking and pooling of food in the mouth
- · Medication side effects that cause drowsiness and/or relax muscles causing delayed swallowing and suppression of gag and cough reflexes
- · Poor chewing or swallowing skills
- · Aging
- · Muscular-Skeletal impairments that may leave individuals unable to sit upright while eating
- · Nutrition, hydration and medication administered via feeding tube
- · Providing fluid and/or food consistencies that are not part of an individual’s dining plan
- · Seizures that may occur during eating and/or drinking, or failure to position a person on their side after a seizure causing oral secretions to enter the airway
Signs and symptoms that may indicate aspiration risk:
Caregivers should notify a physician, RN, and/or clinician if any of the following are observed or identified.
- · Eating slowly, fear or reluctance to eat, gagging/choking during meals
- · Persistent coughing during or after meals
- · Irregular breathing, turning blue, moist respirations, wheezing or rapid respirations
- · Refusing foods and/or fluids
- · Eating in unusual positions (e.g. head back, hyperextended neck, slumped over, etc.)
- · Food or fluid falling out of the person’s mouth, or drooling
- · Intermittent fevers
- · Vomiting, regurgitation, rumination and/or odor of vomit or formula after meals
- · Refusing to eat except from a favorite caregiver
- · Chronic dehydration
- · Unexplained weight loss
Immediate Interventions for Signs of Aspiration:
- · Stop feeding/eating immediately (may restart with approval of the Supervisor or Health Care Professional)
- · Keep person in an upright position and allow for coughing
- · Call 911 if the person has difficulty or stops breathing and/or has no pulse. Start rescue breathing or CPR as appropriate.