Bronch for pt who chokes on dinner?

[CrabbyPatty]

Here's the scenario:

Pt chokes on meatloaf, exact amount unknown. He coughs some up, airway not obstructed.

Shouldn't a bronchoscopy be done in case some of the food is in the patient's lungs? If not, can't they end up with pneumonia?

Obviously, we all choke on our food at some point and don't end up with pneumonia, but just curious.

[GreyGull]

If the patient can still cough and/or be suctioned, then no a bronchoscopy is not necessary. The bronchoscopy itself presents risks also.

Any aspiration runs the risk of pneumonia. Identifying and early treatment is key. When it is a single witnessed event, that makes it fairly easy. When a patient continuous aspirates over a long period of time and it is not recognized, those become more difficult to treat and manage. Identifying and preventing before aspiration happens is even better which make SLPs in big demand right now.

[CrabbyPatty]

If the patient can still cough and/or be suctioned, then no a bronchoscopy is not necessary. The bronchoscopy itself presents risks also.

Any aspiration runs the risk of pneumonia. Identifying and early treatment is key. When it is a single witnessed event, that makes it fairly easy. When a patient continuous aspirates over a long period of time and it is not recognized, those become more difficult to treat and manage. Identifying and preventing before aspiration happens is even better which make SLPs in big demand right now.

Thanks for your reply; makes sense.

I do have a question though, what are "SLPs"?

[GreyGull]

I do have a question though, what are "SLPs"?

Speech Language Pathologist

Speech Therapist

[CrabbyPatty]

Speech Language Pathologist

Speech Therapist

Of course!

I do have a question though, where you work, do RN's do swallow evals first and if there's a problem, then move on to referral of a Speech & Swallow Therapist?

[GreyGull]

Of course!

I do have a question though, where you work, do RN's do swallow evals first and if there's a problem, then move on to referral of a Speech & Swallow Therapist?

Yes an RN can do a simple eval. However, for CVAs, TBIs (traumatic brain injury), SCIs(spinal cord injury), prolonged intubation and trach patients, the SLP should be consulted. There is also a good chance the patient won't be eating while in the ICU and may pass a simple swallow study but runs into problem when they are moved to other floors and their diet is advanced on the belief the patient "passed" a simple swallow eval.

[msmiranda21]

Ther is no immediate need for a bronch if patient's airway is not obstructed and shows good oxygenation thru sats probe. Anyways, if that food particle has gone down the wrong way - the patient will continously cough/be irritated by this foreign body!