From the Guidelines
If you suspect food aspiration, immediately encourage the person to cough forcefully to try to expel the foreign material, as coughing can help prevent aspiration pneumonia, which has a high mortality rate ranging from 20 to 65% 1. When a person experiences food aspiration, it is crucial to act quickly to minimize the risk of complications.
- Encourage the person to cough forcefully to expel the foreign material, as this can help prevent the material from entering the lungs.
- If the person is coughing effectively, continue to encourage coughing while monitoring their breathing, as this can help clear the airway.
- For severe cases where the person cannot breathe, speak, or cough effectively, perform the Heimlich maneuver (abdominal thrusts) by standing behind them, wrapping your arms around their waist, making a fist with one hand, placing it just above their navel, grasping your fist with your other hand, and pulling inward and upward with quick thrusts until the object is expelled.
- If the person becomes unconscious, lay them on their back, call emergency services, and begin CPR if trained, as this can help prevent further complications. It is essential to note that aspiration can occur without coughing, especially in certain populations such as the elderly or those with abnormal oral-pharyngeal swallowing 1. After the immediate emergency has passed, seek medical attention as aspiration can lead to pneumonia or lung damage even if breathing seems normal, as food particles in the lungs can cause inflammation, infection, and respiratory complications 1.
From the Research
Immediate Actions After Food Aspiration
- Induce coughing to help remove the aspirated material from the airways, as seen in a case where a capsule endoscope was aspirated and successfully removed via bronchoscopy after inducing the patient to cough 2.
- Monitor the patient closely for signs of respiratory distress or other complications, as aspiration can lead to serious conditions such as aspiration pneumonia 3, 4, 5.
Preventing Further Complications
- Identify patients at risk for aspiration, such as those with swallowing disorders, and take steps to prevent aspiration, including placing the feeding tube in the duodenum endoscopically for patients with swallowing difficulties 2, 6.
- Use clinical risk factors to identify patients at high risk for aspiration, as monitors such as glucose oxidase and gastric residual volumes are insensitive and unreliable 4.
Management Strategies
- Provide supportive care, as prophylactic antimicrobial therapy has not been shown to improve outcomes in patients with acute aspiration pneumonitis and may lead to unnecessary antibiotic use 5.
- Consider the use of strategies to reduce the risk of aspiration, such as elevating the head of the bed and using a feeding tube with a built-in anti-aspiration valve, although more research is needed to determine the effectiveness of these strategies 6.