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Sunday September 22, 2013 MYT 12:00:00 AM
Sunday September 22, 2013 MYT 7:37:16 AM
by datuk dr musa mohd nordin
Chest x-rays are often used to assess the progress of treatment for pneumonia. – Reuters
Learn more about aspiration pneumonia, what causes it, and what to do if it happens to your child.
IN general, pneumonia is a term used to describe any infection in the lungs.
Aspiration pneumonia suggests pneumonia that results from something that is accidentally inhaled. It occurs when your child accidentally inhales food, drink, vomit or saliva.
If gastric acid from the stomach enters the lungs, it causes chemical pneumonia. Aspiration of bacteria from the saliva causes bacterial pneumonia, while aspiration of a foreign body causes an acute respiratory emergency, and in some cases, may predispose the patient to bacterial pneumonia.
The ones at risk
Pneumonia can affect anyone, but those at highest and greatest risk are infants, children younger than two years old, and individuals older than 65 years of age.
The following conditions may also increase your child’s risk of developing this particular disease:
·Exposure to cigarette smoke, or being in close proximity to smokers.
·Having chronic diseases like asthma, chronic obstructive pulmonary disease, and heart disease.
·Weakened/suppressed immune system, due to factors such as HIV/AIDS, organ transplant, chemotherapy for cancer or long-term steroid use.
·When your child’s normal gag reflex is disturbed; this could be caused by brain injury or having problems swallowing.
What are the symptoms?
If your child exhibits any of the following symptoms, make sure you seek immediate medical attention:
·Bluish discoloration of the skin; usually caused by lack of oxygen.
·Complains about chest pain.
·Coughs up foul-smelling, greenish or dark phlegm (sputum), or if the phlegm has pus or blood.
·Abnormal feelings of tiredness or fatigue.
·Shortness of breath, which may or may not be accompanied by wheezing.
·Problems swallowing food or drinking water.
How is it diagnosed?
Your child’s paediatrician will review your child’s symptoms and examine him. A physical examination may reveal crackling sounds in the lungs, decreased oxygen, rapid pulse (fast heartbeat) and decreased mental awareness.
There are several types of tests that your child may also need. One of the first things that your child’s paediatrician may do if aspiration pneumonia is suspected is to collect samples of blood and sputum from your child.
This procedure involves getting a sample of blood to check your child’s blood oxygen level to see how well your child’s lungs are functioning. At the same time, a lab test will also be done on a sample of your child’s sputum.
Your child’s paediatrician may also order a chest X-ray to determine if there are foreign materials within your child’s lungs; their presence may be the sign of a lung infection.
Another alternative is a CT scan of your child’s chest. This may be needed to check whether there is pus collecting in his lungs.
Some of the other diagnostic methods available include either thoracentesis (needle aspiration) or bronchoscopy (instrument inserted into the upper airway to visualise the breathing tubes and lungs).
How is it treated?
Aspiration pneumonia often needs several weeks of treatment with an antibiotic. While aspiration pneumonia is usually treated with intravenous (IV) antibiotics, its severity will determine whether treatment is carried out at home or in the hospital.
Once your child starts recovering, he may be allowed to switch to oral medicine.
If the chest X-ray shows a lot of fluid or pus in the lungs, a drainage tube may be inserted through the chest wall. The tube drains infected material from the lungs.
The tube will be removed when the drainage stops and chest X-rays show improvement. In severe cases, a ventilator to help your child breathe may be required.
Preventing aspiration pneumonia
Some pneumonias can be prevented by immunising your child with the pertussis, measles, Haemophilus influenza type b, influenza and pneumococcal conjugate vaccines.
Older adults above 50, smokers and people with chronic conditions may also opt for the pneumococcal conjugate vaccines.
You should also teach your child about the need for good hygiene. Washing of hands and oral hygiene is especially important; good personal hygiene can prevent not just aspiration pneumonia, but many other diseases as well.
It is also crucial that you never expose your child to tobacco smoke. The dangers of second-hand and even third-hand smoke cannot be underestimated; this smoke may come from cigarettes, shisha, etc.
You will also need to be alert; if your child has problems swallowing, talk to your doctor and speech specialist about ways to help prevent aspiration.
In the event that your child needs surgery, be sure to follow the doctor’s orders pertaining to fasting before the surgery to decrease the chance of vomiting while unconscious.
Remember that your child’s life is too precious for things to go wrong. Take the necessary steps to prevent this serious complication and make sure your child is never in harm’s way.
n Datuk Dr Musa Mohd Nordin is a consultant paediatrician and neonatologist. This article is a courtesy of Malaysian Paediatric Association’s Positive Parenting programme, supported by an educational grant from Pfizer. The opinion expressed in the article is the view of the author. For further information, please visit www.mypositiveparenting.org. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice.
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