How to Reduce the Risk of Aspiration Pneumonia

Aspiration pneumonia is common among seniors, people with dysphagia, and people with chronic breathing disorders. It can also occur during or following surgery, or subsequent to a sudden trauma. Mortality rates vary greatly, and rise with patient age and comorbidities, as well as the total volume of aspirated fluids. Among those with emphysema, it may be as high as 20 percent. Reducing the risk of aspiration pneumonia can save lives, reduce healthcare expenditures, and prevent health system crowding. 


Risk Factors for Aspiration Pneumonia

There are many risk factors for aspiration pneumonia. Knowing whether and when a patient is at risk makes intervening easier. Be mindful of these threats:

  • Advanced age. Geriatric populations have a higher risk of aspiration, particularly if they have chronic obstructive pulmonary disease (COPD), dementia, or dysphagia. Some research suggests that age itself is not a risk factor, but rather increases the risk of other risk factors. 
  • Weak or impaired swallowing, which may result from stroke-related dysphagia. 
  • Poor ciliary transport, as with smokers. 
  • Weakened ability to clear airway secretions. 
  • Dementia-related swallowing disorders. Many patients with primary progressive aphasia, a frontotemporal dementia that attacks speech, eventually develop swallowing difficulties. 
  • Emergency surgery. 
  • Traumatic injuries that affect the brain or spinal cord, or that damage the airway or surrounding structures. 
  • Suctioning, which can prevent aspiration when performed correctly, can also be a risk factor for aspiration. This is because suctioning usually indicates an underlying risk factor, and because incorrect suctioning technique can damage the airway

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Strategies for Preventing Aspiration Pneumonia 

Health providers can adopt a number of strategies to reduce the risk of aspiration. Those include: 

  • Avoid the use of medications that may affect swallowing or saliva flow. 
  • Provide prompt and evidence-based treatment for medical conditions that increase the risk of aspiration, such as emphysema. 
  • Refer for a swallowing evaluation of swallowing therapy when a patient has dementia or a stroke history and shows signs of dysphagia. 
  • Avoid unnecessary medical interventions, particularly tube feeding. Hand feeding is a safer alternative, so try other alternatives first. 
  • Consider liquid diets for dementia and stroke patients with swallowing disorders. 
  • Suction patients during medical procedures that increase the risk of aspiration. Medical suction during dental procedures, for example, lowers aspiration risk, increases patient comfort, and may prevent choking. 


Know the Signs of Aspiration

To properly treat a patient, you must know the signs of aspiration. They include: 

  • Sudden hoarseness
  • Sudden increase in respiratory symptoms
  • Confusion 
  • Fever and chills
  • Crackling breathing or chest sounds 


Older adults, especially those who are very ill, may exhibit fewer signs than younger, healthier counterparts. So monitor not just for signs of aspiration, but also for obvious risks. For example, if a senior has been pocketing food or coughing after drinking, they may be at risk for aspiration. 


Choosing the Right Aspiration Pneumonia Equipment

The right equipment can both prevent and treat aspiration pneumonia. In the operating room and among patients who cannot clear their airway secretions, suction is the primary weapon in the fight to prevent aspiration. When a patient begins aspirating, prompt suctioning can save their life. Aspiration mortality directly correlates with the volume of aspirate a patient inhales. 


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Editor's Note: This blog was originally posted in May of 2020 and has since been updated with newer content.