Tuesday, 28 May 2013

Reflective log 28.05.13 – Aspiration pneumonia



1. Think of a recent therapy session or event.
My patient sounded very chesty and gurgily on a Saturday. She had recently been put on 3 yogurts a day. On a swallow examination the patient was able to manage the yogurt with one throat clear post swallow. She appeared to have a weakened swallow and slightly delayed swallow trigger. On water the patient coughed clearly post swallow.

2. Describe the session/experience
I put made the patient nil by mouth and assumed the patient may have had an aspiration pneumonia. I was surprised that this would have happened so quickly and that the patient would sound so gurgily/ chesty as their only inralke was 3 yogurts a day. The patient had been on a puree meal at her last hospital, an NG-tube was put in place over the weekend due to the patient inhaling some soup. The patient was transferred to us with a NG tube. The doctor found that the patient’s NG-tube had been dislodged. This may have meant that the patients aspiration was due to her tube feeding.

3. What did this session make you feel?
I felt that I may have missed some signs of aspiration. As the patient had clearly aspirated on water and shown clear indicate=ors ithought that it was odd that they had not shown any indicators when eating yogurt and had aspirated. I had acted cautiously by putting the patient on 3 yogurts a day rather than backl on a puree meal.

4. What would you want to change, and why?
I would have asked the doctor whether they thought the patient had developed aspiration pneumonia due to their oral intake much sooner.

5. What has this session has taught you?
- Ask/ find out the reason for chest infections since it may not be related to oral intake.

6. What do you need to learn or find out before the next event?
Other causes of pneumonia

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