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State of Connecticut Department of Developmental Services

ASPIRATION AND REFLUX PRECAUTIONS

Aspiration Precautions

Aspiration precautions are interventions to reduce the risk of aspiration of food, liquids, and/or secretions during the swallowing process. These interventions may include: Positioning the person in an upright position to 90 degrees while eating or taking oral medications Positioning the person to maintain an upright position for one hour after eating Providing instruction and direction to staff to immediately report to nursing staff all changes to the person's baseline especially : Increased coughing Increased secretions or changes to secretions (color, texture) Change in respiratory status Fever

Reflux Precautions

Reflux Precautions are specific orders prescribed for an individual who has been identified to be at significant risk of aspiration due to gastroesophagael reflux. These orders should include: Positioning the person in an upright position to 90 degrees while eating or taking oral medications Positioning the person to maintain an upright position for one hour after eating Avoidance of positioning the person in a flat position. Any procedure that may be required to be performed that would require the person to lie flat, would be for as brief a time as possible and when practical scheduled during periods of least risk such as on an empty stomach. At these times, the observation of the individual shall be increased. An incline block/wedge will be used in the person's bed to keep the head of the bed elevated if the person is not in a hospital bed. Individual should receive a reflux modified diet which reduces/ restricts the following items: Acidic foods Fatty foods Caffeine Staff shall receive training and direction to immediately report to nursing staff all changes to the person's baseline especially : Increased coughing Increased secretions or changes to secretions (color, texture) Change in respiratory status Fever

Health Standard # 07-1 Attachment H

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