Management of Pulmonary Debris from Aspiration in Elderly Patients

Initial Assessment and Management

Administer supplemental oxygen (10 L/min) when necessary to improve respiratory status and enhance clearance of aspirated material 1

Consider bronchoscopy for direct removal of large debris or when other clearance methods fail, especially in patients with significant respiratory compromise 2

Be cautious with β-agonist nebulization in elderly patients with ischemic heart disease; monitor ECG during first dose administration if cardiac history is present 3
Consider anticholinergic nebulized treatments (ipratropium bromide) as elderly patients often respond better to these than to β-agonists 4
When using anticholinergic medications, use a mouthpiece rather than face mask to avoid risk of acute glaucoma or blurred vision, particularly common in elderly patients 4