Aspiration is inhalation of foreign material below the vocal cords. In anesthesia practice, the inhalation of gastric content is rare 1 per 2000-3000 cases occurrence, however the consequences of the complication can be detrimental (Raghavendran, Nemzek, Napolitano, Knight, 2011). Presentation of the pulmonary aspiration ranges from silent aspiration, where the patient does not experience any symptoms, to the development of acute lung injury (ALI). The mortality rate after development of ALI reaches 44% (Richter, Bergmann, Knels, Hofheinz, Kasper,…Koch, 2013). Patients that undergo emergency surgery should be considered to be at risk for aspiration, due to decreased gastric motility, as a result of pain, stress, and opioid administration.
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He was struck by car earlier that evening, at the stop light. The car approached at the approximate speed of 30 miles per hour and hit him on the left side. On the arrival, he complained of pain 7/10, on the numeric scale, in his left lower extremity. Fentanyl 100 mcg and dilaudid 1 mg was administered for pain management, prior to the interview with the anesthesiologist. Past medical history included Hodgkin’s lymphoma, in remission since 1978, gastro-esophageal reflux disease (GERD), and hypothyroidism. GERD was well-controlled by Prilosec, patient was taking Synthroid for hypothyroidism. Patient denied smoking history, stated he drinks alcohol occasionally, but did not have alcohol today. Past surgical history included splenectomy. No previous anesthesia complications were reported. Physical examination showed clear lung sounds, Mallampati score II, no heart murmurs, and soft abdomen. Patient was quiet and cooperative. Skin was pale and dry. Immobilization splint was applied to the left lower leg. Patient reported last fluid or food intake 12 hours prior to the …show more content…
However, the patients with suspected aspiration should be monitored closely for signs and symptoms of pneumonitis. The majority of symptoms will develop within 2 hours post aspiration. Some symptoms of aspiration include the development of new cough, wheezing, hypoxemia, and radiologic changes. The oxygen saturation decrease of 10 or more percent, when compared to the preoperative oxygen saturation, is suggestive of the development of pneumonitis (Nagelhout,
He was struck by car earlier that evening, at the stop light. The car approached at the approximate speed of 30 miles per hour and hit him on the left side. On the arrival, he complained of pain 7/10, on the numeric scale, in his left lower extremity. Fentanyl 100 mcg and dilaudid 1 mg was administered for pain management, prior to the interview with the anesthesiologist. Past medical history included Hodgkin’s lymphoma, in remission since 1978, gastro-esophageal reflux disease (GERD), and hypothyroidism. GERD was well-controlled by Prilosec, patient was taking Synthroid for hypothyroidism. Patient denied smoking history, stated he drinks alcohol occasionally, but did not have alcohol today. Past surgical history included splenectomy. No previous anesthesia complications were reported. Physical examination showed clear lung sounds, Mallampati score II, no heart murmurs, and soft abdomen. Patient was quiet and cooperative. Skin was pale and dry. Immobilization splint was applied to the left lower leg. Patient reported last fluid or food intake 12 hours prior to the …show more content…
However, the patients with suspected aspiration should be monitored closely for signs and symptoms of pneumonitis. The majority of symptoms will develop within 2 hours post aspiration. Some symptoms of aspiration include the development of new cough, wheezing, hypoxemia, and radiologic changes. The oxygen saturation decrease of 10 or more percent, when compared to the preoperative oxygen saturation, is suggestive of the development of pneumonitis (Nagelhout,