A pulmonary aspiration is when food, liquids, drinks, stomach contents or secretions enter the lungs or respiratory tract. It is frequently referred to as something that "went down the wrong pipe." In many cases, the patient will recover without any injury or pneumonia. However, there are certain patients who are at a greater risk of choking or aspirating and developing a chemical pneumonitis, trouble breathing, sepsis, pneumonia, asphyxiation or lack of oxygen, brain damage or even death.
Patients who are at high risk of aspirating or choking are those with traumatic brain injuries, alcohol intoxication, drug overdoses, general anesthesia, full stomachs, decreased level of consciousness, sedatives, sleeping pills, obesity, pregnancy, tracheal intubation, feeding tubes or generalized weakness. Because these patients are at a higher risk of aspirating, the American Association of Critical-Care Nurses (AACN) issued a practice alert on aspiration prevention.
Based on their latest findings, the AACN recommends the following actions to help prevent aspirations or choking episodes:
- Increase the patient's head of the bed to a 30 - 45 degree and angle unless contraindicated.
- Administer the least amount of sedative medications if possible.
- Check or assess placement of a patient's feeding tube every four hours.
- Check or assess patients with gastric tubes every four hours for feeding intolerance.
- Avoid bolus feedings or large feedings all at once in patients who are at high risk for aspiration.
- Consult with a physician prior to any oral feedings to see if a swallowing study or assessment should be performed.
- Make sure there is proper endotracheal cuff pressure.
- Do not deflate an endotracheal cuff until all secretions are cleared or suctioned from above the cuff.
The AACN's practice alert is a good reminder for all nurses to make sure they take these minor necessary steps in hopes of preventing an aspiration or choking episode in their high risk patients. Unfortunately, not all nurses follow these aspiration precaution steps and patients wind up choking or aspirating and developing lung problems or even death.
Here at the Philadelphia Beasley medical malpractice law firm we have reviewed hundreds of cases where patients aspirated while in the hospital. Our experienced teams of physicians and critical care nurses have spent thousands of hours in a hospital setting taking care patients that aspirated. If you or a loved one aspirated while in the hospital and developed a pneumonia, lack of oxygen to the brain or died please feel free to call one of our experienced lawyers, doctors or nurses at (215) 866-2424 for a strictly confidential and free consultation. Since 1958, we have had two of the highest medical malpractice verdicts in Pennsylvania and have been awarded over $2 billion on behalf of our injured clients.