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Anaesthesia Miscellaneous 838debb7

A 72-year-old man has multiple injuries and an altered sensorium after a high-speed motor vehicle collision. He is intubated for his decreased mental status. During intubation, a large amount of gastric contents are noted in the posterior pharynx and he aspirates. Which of the following is the appropriate initial treatment?

A
Bronchoscopy for aspiration of paiculate matter
B
Steroids
C
Prophylactic antibiotics
D
Inhaled nitric oxide
High-Yield Explanation
Bronchoscopy is indicated for aspiration pneumonitis if there is paiculate matter in the tracheobronchial tree. Prophylactic antibiotics are not indicated after gross aspiration, which results in a chemical pneumonitis. Antibiotics are indicated only if pneumonia develops. Steroids and inhaled nitric oxide are not indicated for aspiration pneumonitis. High positive end-expiratory pressure is not required in patients unless respiratory failure develops.

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