4.5 Aspiration a serious complication of dysphagia

Coughing and choking are two of the most distressing aspects of swallowing problems.  Aspiration happens when food, drink or saliva ‘goes down the wrong way’, and enters the lungs instead of the stomach. Usually when this happens a healthy person will cough to try and get the material out of the lungs.

Aspiration is very dangerous, not only at the time, but later.  If a small piece of food enters the lungs, causing irritation in the lungs or damaging them, this can cause a chest infection, known as aspiration pneumonia.   

If there is a risk of aspiration, then you may be put on a Nil by Mouth regime, to reduce this risk.  Some individuals may not cough or show any outward signs of a swallowing problems or aspiration. This is called silent aspiration.  

This section contains some practical resources and academic articles about aspiration. As such, this information is likely to be of interest to: 

·         Staff working in health and social care

·         Trainers delivering sessions about dysphagia

·         People with swallowing problems and their families and friends

·         Students studying health and social care.

See your doctor, nurse or speech and language therapist about investigations and advice about how to reduce the risks of aspiration.   

Resources

On-line resources

Metheny NA (2012)  Preventing Aspiration in Older Adults with Dysphagia. Available here.

The Hartford Institute for Geriatric Nursing, New York University, College of Nursing.  Available here.

NHS Choices, complications of dysphagia, see link.

NHS Choices has instructions about what to do if someone is choking, see  link.

 

Articles

Eisenstadt S (2010) Dysphagia and aspiration pneumonia in older adults. Journal of the American Academy of Nurse Practitioners, 22(1):17-22. doi: 10.1111/j.1745-7599.2009.00470.x.

Ramsey D et al (2005) Silent aspiration: what do we know?  Dysphagia, 20(3):218-25.