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What procedures should be taken to prevent aspiration.

67 year old male patient diagnosed with pancreatic cancer underwent a Whipple procedure, was transferred to a basic care ward after 11 hours in ICU. Showed symptoms of Delayed Gastric Emptying, vomiting. What procedures should be taken to prevent aspiration.
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replied April 29th, 2014
Thank you for asking!
If the patient is conscious and can sit the position should be modified with 30 to 45 degree layback. Patients should be turned and repositioned frequently to maximize drainage of oropharyngeal secretions. The head of the bed should be placed at 30o-45o unless contraindicated (e.g., hypotension, orthopedic abnormalities of the spine or hips). During oral intake, elevating the head of the bed to 90o with hips and knees at the same angle to the midline of the trunk is ideal; feet should be flat on the floor ('Identification and Nursing Management of Dysphagia in Adults With Neurological Impairment'). High Fowler,s position can be used in bed-ridden patients. Flexing the head slightly forward to drop the chin down is recommended for those with neurologic deficits such as brain tumors
The best way to avoid aspiration is keep the stomach empty, nothing by mouth unless totally conscious .
If the unconscious then tracheal intubation is the best way to avoid the aspiration with the cough inflated and mechanical vent put on.
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