what would be your 1st intervention for pt aspirating?

[IngyRN]

What do you do when your pt who has a h/o CVA new SDH w/high aspiration risk, is aspirating on lunch, coughing, turning bright red, w/hob 90 degrees. anterior LS sound rhonchorous sats 93% ra. What would your first intervention be?

[icyounurse, BSN, RN]

My first intervention would be to maintain the airway. Of course, I would put in a call to MD and remove food and fluids from the patients bedside. If the airway is ok there probably needs to be a swallow eval done before the pt can eat again.

[Wise Woman RN]

First thing would be to take the food and drink away... then notify MD. He may order speech eval and video swallow... and chest xray, antibiotics, etc...

[litbitblack, ASN, RN]

Maintain the airway. Use suction if unable to cough it up. May need o2. Npo until further notice. Notify md for swallow study.

[leslie :-D]

Maintain the airway. Use suction if unable to cough it up. May need o2. Npo until further notice. Notify md for swallow study.

yes, yes and yes!

also, get order for abx stat...

as we know asp pneumonia will be forthcoming- usually within few hrs.

leslie

[uscstu4lfe]

no more food/liquids for you! make sure a suction catheter is at the bedside and connected in case the pt starts to choke on their own secretions. call the doc and ask him what he wants to do.

[UM Review RN, ASN, RN]

Maintain airway, HOB up, listen to breath sounds, take O2 sat, call Resp. therapy, suction if necessary, call doc, get stat CXR order, IV fluids, and antibiotic. NPO till after video swallow study, of course.

[AnnaSL, BSN, RN]

The px as we speak is CVA, so definitely as part of assessment, swallowing is altered, which side is weaker, as part of the ASPIRATION PRECAUTION, we should be knowledgeable which part is weak.. and promote to swallow on this part.

if Px is actually aspirating, AIRWAY is important... remember your ABC's

so just incase he is aspirating, definitely, a suction should be readily be available, but take note, dont just suction, have the time to hyperoxygenate or just oxygenate (between suctioning) :redbeathethe px..

Then report..:typing

[nerdtonurse?, BSN, RN]

All of the above, plus if the CVA was this admission, I'd do a neuro check and compare to previous -- is the stroke exacerbating? If the hx of CVA is not recent, are they having another one?

Bad can always be worse...

[GOMER42]

What? You don't offer him another drink to wash it down?

[platon20]

yes, yes and yes!

also, get order for abx stat...

as we know asp pneumonia will be forthcoming- usually within few hrs.

leslie

I dont agree with getting abx yet. You dont routinely start abx just because people are choking. Get a CXR first, and if he's febrile then by all means use abx but you need some positive data that he's really got an infection first, otherwise what are you treating?

[rhondaa83]

My first question would be why is the patient in bed eating?