How do you prevent aspiration in a patient with severe muscle weakness?
Elevation of the head of the bed
Stupid question
Antibiotic prophylaxis isn't an answer they usually like to see. Mainly because it can lead to antibiotic resistance.
In this paper, prophylaxis doesn't improve outcomes in patients who have already aspirated and gotten pneumonitis (inflammation without infection), so it definitely wouldn't help before this patient even aspirates.
https://pubmed.ncbi.nlm.nih.gov/29438467/
NG suction addresses stomach contents, not oral secretions.
Patient with severe muscle weakness who has developed fever, hypoxia, new infiltrates in the middle/lower lobes and a polymicrobial infection via bronchoscopy, most consistent with aspiration pneumonia
unrulynightfallIn this question, why would elevating the bed help? She still will have oral secretions containing flora that cannot effectively empty into the stomach. Aspiration of oral secretions will still occur leading to aspiration PNA. This is the same reason an NG tube wouldn't necessarily prevent infection. Instead, cephalosporins that cover Gram +/- could have prevented the infection assocaited with her inevitable aspiration, right?+
azibirdDidn't research this in depth but I don't think antibiotics are commonly indicated for PROPHYLAXIS. Perhaps there are select exceptions. NG tube wouldn't help with oral secretions, it's in the stomach.+
submitted by โazibird(279)
How do you prevent aspiration in a patient with severe muscle weakness?
Elevation of the head of the bed
Stupid question
Antibiotic prophylaxis isn't an answer they usually like to see. Mainly because it can lead to antibiotic resistance.
In this paper, prophylaxis doesn't improve outcomes in patients who have already aspirated and gotten pneumonitis (inflammation without infection), so it definitely wouldn't help before this patient even aspirates. https://pubmed.ncbi.nlm.nih.gov/29438467/
NG suction addresses stomach contents, not oral secretions.