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Author: Admin | 2025-04-28
Signs of aspiration. We don’t want to recommend something that may be unsafe, but we certainly think he should be able to swallow something. An in-depth discussion of the pros/cons of any clinical decision with the interdisciplinary team (IDT) is always recommended, but is especially important when confronted with a complex case with multiple factors and multiple options. Some discussion questions to bring up with the IDT may include: Can an instrumental study be completed? When? If not, why not? If a swallow study can’t be completed, might it be safe to advance the patient to some level of PO from the results of your clinical assessment? Consider the risk of aspiration, silent aspiration, and dehydration/malnutrition when making this decision.What are the patient’s risk factors for aspiration pneumonia and how do these play into the risk profile? How long can the patient safely go without their medication? Can the medication be administered via an alternative source, at least temporarily (IV or NGT)? Do the risks of that food source outweigh the risks of PO? TakeawaysNPO except for meds is sort of contradictory, isn’t it? If a patient is NPO except for meds, they aren’t actually NPO. In fact, they are taking in something that is potentially more dangerous to the lungs than food or liquid. And on the other side of the argument, if they are safe to take meds by mouth, why aren’t they safe to take other consistencies throughout the day (i.e. small amounts of ice, water, and/or puree as tolerated with supervision)? This question and the others posed in this article will hopefully lead you to a thoughtful consideration for what’s best for the patient and give you a loose outline to use with your IDT when making some tough calls. Remember, you’re not alone. A good team is greater than the sum of its parts and you’ll need that large sum when addressing these multi-faceted questions.Liked this? Why not share it.Leave a comment. I feed on feedback.
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