The occurrence of aspiration is a common situation in clinical and daily life. However, many people do not understand the specific concept of aspiration and the causes and consequences of aspiration. The popular and folk saying for aspiration is "choking, choking". From a medical perspective, it refers to a certain amount of liquid or solid (including secretions, blood, etc.) during swallowing when eating or not eating. The phenomenon of entering the airway below the glottis. These liquids or solids include food, drugs, gastroesophageal reflux, oropharyngeal secretions, foreign bodies, etc.
Why are the elderly prone to aspiration? I sum it up as the following 4 points:
1, age factor
Growth is the most common factor. With age, the esophageal sphincter relaxes, the pharyngeal sensation decreases, swallowing reflex and coughing The reflex is weakened, and gastroesophageal reflux is prone to cause aspiration.
2, disease factors
Cerebrovascular accidents, chronic obstructive pulmonary disease, senile dementia, Parkinson’s disease, malignant tumors, etc. patients are prone to aspiration; long-term bed rest nasal feeding diet The esophageal sphincter is relatively incompletely closed, and the contents of the stomach are easily refluxed to the oropharynx to cause aspiration; some sedatives and other drugs are required due to the condition, which may increase the risk of aspiration.
3, Position factors
Wrong eating positions, such as lying down and eating with the head up, are prone to aspiration.
4. Care personnel factors
Elderly persons unable to take care of themselves Due to the lack of common sense and experience of caregivers, the elderly can cause aspiration, and the feeding process is too fast, too rush, and too much. And so on will increase the chance of aspiration.
Understanding the above 4 reasons, what should the elderly pay attention to during the whole process of eating?
1, before eating
A comfortable and quiet environment should be created, including certain lighting in the room, suitable temperature, avoid noise, easy to concentrate, take an upright sitting position or a slightly forward sitting position Eat later. If you cannot maintain a sitting position, raise the head of the bed 30°-45°, tilt your neck slightly forward, and use pillows to maintain your position.
2、吃食中
Elderly people with autonomous eating ability should eat small mouths, swallow with their heads low, and chew slowly when eating to ensure adequate Swallowing time. The food is mainly mushy food that is easy to swallow, such as porridge, custard, vegetable puree, etc. Avoid dry, hard, finely divided foods such as biscuits, rice, peanuts, large pieces of meat, food with bones, soup with rice, meat porridge Wait.
Elderly people with nasal feeding should check whether the position of the nasogastric tube is correct before eating. The amount of feeding should not be too much each time, about 200ml is appropriate, the injection speed should not be too fast, and the interval between meals 2 hours is appropriate. Check the residual fluid in the stomach before each feeding to ensure that the residual fluid is less than 50% of the previous feeding volume. If the residual fluid is large, the feeding time should be extended.
3, after eating
It is not advisable to rest in the supine position immediately, and should remain in the sitting or semi-recumbent position for more than 30 minutes to prevent gastric reflux. Do not turn over or pat your back immediately after eating, rinse your mouth in time, keep your mouth clean, and use dental floss to clean the gaps between teeth if necessary.
The above three important links in the eating process If the elderly are in place, or their family members can take care of them, the risk of aspiration can be greatly reduced, so no matter what Whether it is the elderly themselves or their family members, let's learn!
我是@医路前行的 digestion people, focusing on the promotion of medical science related to digestion. Later, I will talk about the hazards of aspiration and first aidLaw, stay tuned. Health Science Challenge Healthy May Day
