Aspiration – A respiratory emergency
Aspiration is the introduction of solids or liquids into the lungs. The presence of any substance other than breathable air impedes the perfusion in the alveoli, while the substance itself may also have damaging properties to the lung and airway tissues. Common aspirations include water, food, vomit, foreign objects or small particulates. The first three are easily introduced by the oropharynx by some sort of misdirection into the larynx rather than the esophagus. Children are extremely likely to choke and aspirate small objects, such as pebbles from the yard or pieces of plastic toys. This can present as both an upper airway obstruction and a lower airway aspiration, once the object has made its way …show more content…
In the case of choking on food or water that then becomes fully inhaled into the lungs, anyone can be a victim in need of immediate help. Often however, EMS providers will find aspiration to be a complication of some other medical emergency. In the case of a respiratory or cardiac arrest, basic airway adjunct ventilations are prone to fill the stomach with air as well as lungs. When the stomach becomes too distended, the patient will vomit even while they are unconscious. The vomitus now in the pharynx is pushed into the respiratory tract during the mechanical ventilations. This becomes another airway compromise in an already apneic person. Even with patients who are conscious, they often have other medical conditions that inhibit their ability to control their own airway. Such as with patients who cannot sit up or who suffer dysphagia are prime victims for the same vomitus in their airway. These patients are often found in nursing home, hospital, or home health care …show more content…
Healthcare providers, especially EMS, must be very observant of the surrounding circumstances of any respiratory distress. Questioning the onset of sudden dyspnea or apnea may reveal the true cause. What appears to be an intrinsic physiological disturbance such as from asthma or pulmonary edema may have external cause. A young child may have been playing with small toys or feeding himself unsupervised for even just a minute when his parent finds him struggling to breath. EMS need to be vigilant to obtain the history of the scene in order to recognize the true cause of distress. While an elderly patient may have chronic respiratory issues, aspiration of food while eating may be the true acute cause of her rapidly decreasing oxygen saturation. One type of airway compromise that may be overlooked is smoke inhalation. This is a special case in which it can be both a toxic inhalation case and a particulate aspiration situation. Both play a role in the delicate management of this respiratory assault. While a patient pulled from a fire may or may not have severe burns, the presence of smoke in the lungs is almost a guarantee. The hydrocarbons and other smoke particles are essentially micro solids that can clog the alveolar gas exchange as well as damage the surrounding
Aspiration is the introduction of solids or liquids into the lungs. The presence of any substance other than breathable air impedes the perfusion in the alveoli, while the substance itself may also have damaging properties to the lung and airway tissues. Common aspirations include water, food, vomit, foreign objects or small particulates. The first three are easily introduced by the oropharynx by some sort of misdirection into the larynx rather than the esophagus. Children are extremely likely to choke and aspirate small objects, such as pebbles from the yard or pieces of plastic toys. This can present as both an upper airway obstruction and a lower airway aspiration, once the object has made its way …show more content…
In the case of choking on food or water that then becomes fully inhaled into the lungs, anyone can be a victim in need of immediate help. Often however, EMS providers will find aspiration to be a complication of some other medical emergency. In the case of a respiratory or cardiac arrest, basic airway adjunct ventilations are prone to fill the stomach with air as well as lungs. When the stomach becomes too distended, the patient will vomit even while they are unconscious. The vomitus now in the pharynx is pushed into the respiratory tract during the mechanical ventilations. This becomes another airway compromise in an already apneic person. Even with patients who are conscious, they often have other medical conditions that inhibit their ability to control their own airway. Such as with patients who cannot sit up or who suffer dysphagia are prime victims for the same vomitus in their airway. These patients are often found in nursing home, hospital, or home health care …show more content…
Healthcare providers, especially EMS, must be very observant of the surrounding circumstances of any respiratory distress. Questioning the onset of sudden dyspnea or apnea may reveal the true cause. What appears to be an intrinsic physiological disturbance such as from asthma or pulmonary edema may have external cause. A young child may have been playing with small toys or feeding himself unsupervised for even just a minute when his parent finds him struggling to breath. EMS need to be vigilant to obtain the history of the scene in order to recognize the true cause of distress. While an elderly patient may have chronic respiratory issues, aspiration of food while eating may be the true acute cause of her rapidly decreasing oxygen saturation. One type of airway compromise that may be overlooked is smoke inhalation. This is a special case in which it can be both a toxic inhalation case and a particulate aspiration situation. Both play a role in the delicate management of this respiratory assault. While a patient pulled from a fire may or may not have severe burns, the presence of smoke in the lungs is almost a guarantee. The hydrocarbons and other smoke particles are essentially micro solids that can clog the alveolar gas exchange as well as damage the surrounding