Basic Principles Regarding Aspiration Pneumonia Prevention

By Martha Wilson


Aspiration pneumonia is infection of the lungs that occurs as a result of contamination by stomach contents. This usually occurs when the muscles in the gastrointestinal system become weak or paralyzed. Elderly persons, those in intensive care units and those in preparation for surgery have a significantly high risk. It is important that strict measures for aspiration pneumonia prevention are put in place and observed to the letter.

For patients whose muscles are weak or completely paralyzed, feeding should be carried out through a tube that runs from the nostril to the stomach. This tube is medically referred to as a nasogastric tube, NGT. When inserting the tube, it is better to mildly sedate the patient as the process can be very uncomfortable if performed on someone that is awake.

The doctor can request for a check radiograph (X-ray) to ensure that tube has been correctly placed. One should also ensure the tube remains patent by administering only liquids and partial solids. The tubes need to be cleaned from time to minimize the risk of infection. Another precaution to be undertaken is that the caregiver should make sure that the food being administered is not too hot to cause damage to the tube and corrosion to the stomach lining.

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.

Intensive care units need to be diligent in giving care to patients to ensure they do not complicate. Intubation should be done when indicated as it also helps in preventing this complication. Routine screening of the lungs should be carried out to rule out any infections.

In conclusion, prevention of aspiration pneumonia is possible as long as there is commitment from the caregivers. Individuals who are susceptible to aspiration include the very old, those in a coma and those with neuromuscular diseases. Prevention involves basic measures such as monitored feeding and elevating the head of the bed.




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