The ramifications and unintended consequences stemming from COVID-19 continue to reverberate throughout the population.
As if the challenges first responders and health care providers face on a daily basis weren’t already enough, a new crisis has emerged in the form of an old foe – opioids.
Overdose deaths last year increased by nearly 30 percent from 2019, as a record 93,000 people lost their lives primarily as a result of opioids and the proliferation of fentanyl.
In the District of Columbia, 95 percent of overdose deaths were a result of this synthetic opioid offshoot.
Emergency rooms were packed with COVID patients, leaving many people suffering from addiction isolated, locked down, overstressed and challenged to get medication for proper treatment.
In spite of the potential dangers, doctors were also prescribing opioids and other sedatives to COVID “long haulers” at Veterans Affairs facilities who were suffering from health problems months after their initial diagnosis.
Anyone overdosing from opioids or taking sedating medications is also at an increased risk of aspiration, as these types of drugs can affect a person’s ability to swallow. Aspiration refers to the inhalation of foreign material into the lungs and lower airways. This can include blood, vomit, and oropharyngeal secretions, as well as exogenous substances. Aspiration pneumonia can develop as a resulting complication.
With health care resources such as EMTs and emergency room workers exhausted and spread thin, it’s become more of a challenge to monitor the signs of potentially dying from aspiration pneumonia and have a plan in place to quickly and effectively treat it.
Signs, symptoms and complications associated with aspiration pneumonia
When patients have breathing difficulties, medical personnel should always evaluate them for the following signs and symptoms of aspiration pneumonia:
- • Blue lips, tongue, or fingers
- • Difficulty swallowing
- • Shortness of breath or trouble breathing
- • Chest pain
- • Sweating
- • Raspy sounds from the throat or chest
- • Unexplained sweating
- • Symptoms of a lower respiratory infection
Aspiration pneumonia can also cause numerous complications, including:
- • Sepsis
- • Respiratory failure
- • Acute respiratory distress syndrome (ARDS)
- • Bacterial pneumonia
Prompt and effective treatment is essential
In the immediate aftermath of aspiration, a patient may be unable to breathe or swallow, presenting a medical emergency. After the risk of hypoxia has passed, the dangers of aspiration pneumonia have not.
Rapidly clearing the airway is critically important. Following an aspiration event, patients may need hospitalization and continuous monitoring, especially if they swallowed a large volume of contaminated fluid.
The right suction machine can help you promptly intervene to stop or prevent aspiration and to reduce the volume of aspirate a patient inhales.
Suctioning plays an essential role in preventing aspiration. Effective suctioning keeps oral and gastric juices from entering the trachea, where they can be inhaled during respiration or forced deeper into the lungs during assisted ventilations. Here are a few reminders when it comes to suctioning your patients:
- • Keep the suction unit handy—it’s no good to you if it’s not on hand.
- • Check the unit at the start of each shift—ensure your equipment is operational and ready to go.
- • Clean the suction unit after each use—while it can save a life, it can also serve as a contaminant if not properly disinfected.
- • Use proper technique—suction, like any lifesaving procedure, can be ineffective and downright dangerous if not properly utilized.
- o Hyperoxygenate your patient prior to suctioning
- o Limit suction time to prevent desaturation
- o Suction with care to avoid damaging delicate oral tissues
- o Use proper-sized tips to prevent clogs and reduce suction time
Many at risk for aspiration pneumonia continue to be the elderly, the very young (newborns) or people suffering from debilitating mental conditions such as Alzheimer’s or Parkinson’s Disease.
It’s becoming more apparent that because of their increased prevalence, sedatives or opioids have the potential to create significant new challenges in treating this deadly threat. Recognizing the entirety of hazards and having the necessary resources to offset these dangers are essential in the successful prevention of aspiration pneumonia.