AJN, American Journal of Nursing
February 2008, Volume 108 Number 2 , p 42 - 44
Recognizing aspiration. Aspiration may manifest itself as coughing and choking while eating or drinking, as well as by drooling, gurgling sounds when speaking, or hoarseness. Silent aspiration, or aspiration without symptoms, also may occur and is even more difficult to detect. 1 Aspiration of a substance such as food, tube-feeding formula, saliva, or vomitus into the respiratory tract can lead to aspiration pneumonia. While there may be challenges in recognizing aspiration in older adults, it may also be difficult to detect aspiration pneumonia before the occurrence of overwhelming illness. 2 The typical pneumonia symptoms of cough, increased respiratory rate, fever, and chills may not be seen in older adults; delirium, increased confusion, or a fall may be the only apparent initial change.
Several methods can be used to determine whether aspiration is occurring, including bedside swallowing assessment by a specially trained speech pathologist, videofluoroscopy (also known as a modified ...