Overview of aspiration in palliative care

Aspiration is the inhalation of foreign material (eg food, vomit, blood, saliva) into the lungs.

Aspiration is usually a poor prognostic sign in patients with palliative care needs—review the goals of care in patients who have aspirated. Aspiration is often recurrent and difficult to prevent because the cause is often irreversible. Patients with advanced disease, dementia or frailty are at risk of recurrent aspiration events due to impaired swallowing from weakness or reduced consciousness.

Discuss with patients or their substitute decision-makers, and carers, the potential benefits of aspiration prevention measures such as speech therapy or dietary modification (while balancing this with the impact of these measures on quality of life). If possible, also discuss the management of future aspiration events, and the appropriateness of acute hospital admission and antibiotic therapy if aspiration pneumonitis or aspiration pneumonia occurs. For general information on prevention of aspiration pneumonia, see Prevention of aspiration pneumonia in the Antibiotic guidelines.