Aspiration Precautions

Aspiration is the inhaling of a liquid or object into the lungs. Things that can be inhaled into the lungs include:

  • Food.

  • Any type of liquid, such as drinks or saliva.

  • Stomach contents, such as vomit or stomach acid.

When these things go into the lungs, damage can occur. Serious complications can then result, such as:

  • A lung infection (pneumonia).

  • A collection of pus in the lungs (lung abscess).


  • A decreased level of awareness (consciousness) due to:

  • Traumatic brain injury or head injury.

  • Stroke.

  • Neurological disease.

  • Seizures.

  • Decreased or absent gag reflex (inability to cough).

  • Medical conditions that affect swallowing.

  • Conditions that affect the food pipe (esophagus) such as a narrowing of the esophagus (esophageal stricture).

  • Gastroesophageal reflux (GERD). This is also known as acid reflux.

  • Any type of surgery where you are put under general anesthesia or have sedation.

  • Drinking large amounts of alcohol.

  • Taking medication that causes drowsiness, confusion, or weakness.

  • Aging.

  • Dental problems.

  • Having a feeding tube.


When aspiration occurs, different signs and symptoms can occur, such as:

  • Coughing (if a person has a cough or gag reflex) after swallowing food or liquids.

  • Difficulty breathing. This can include things like:

  • Breathing rapidly.

  • Breathing very slowly.

  • Hearing "gurgling" lung sounds when a person breaths.

  • Coughing up phlegm (sputum) that is:

  • Yellow, tan, or green in color.

  • Has pieces of food in it.

  • Bad smelling.

  • A change in voice (hoarseness).

  • A change in skin color. The skin may turn a "bluish" type color because of a lack of oxygen (cyanosis).

  • Fever.


  • A chest X-ray may be performed. This takes a picture of your lungs. It can show changes in the lungs if aspiration has occurred.

  • A bronchoscopy may be performed. This is a surgical procedure in which a thin, flexible tube with a camera at the end is inserted into the nose or mouth. The tube is advanced to the lungs so your caregiver can view the lungs and obtain a culture, tissue sample, or remove an aspirated object.

  • A swallowing evaluation study may be performed to evaluate:

  • A person's risk of aspiration.

  • How difficult it is for a person to swallow.

  • What types of foods are safe for a person to eat.


If you are a caregiver to someone who may aspirate, follow the directions below.

If you are caring for someone who can eat and drink through their mouth:

  • Have them sit in an upright position when eating food or drinking fluids, such as:

  • Sitting up in a chair.

  • If sitting in a chair is not possible, position the person in bed so they are upright.

  • Remind the person to eat slowly and chew well.

  • Do not distract the person. This is especially important for people with thinking or memory (cognitive) problems.

  • Check the person's mouth for leftover food after eating.

  • Keep the person sitting upright for 30 to 45 minutes after eating.

  • Do not serve food or drink for at least 2 hours before bedtime.

If you are caring for someone with a feeding tube and he or she cannot eat or drink through their mouth:

  • Keep the person in an upright position as much as possible.

  • Do not lay the person flat if they are getting continuous feedings. Turn the feeding pump off if you need to lay the person flat for any reason.

  • Check feeding tube residuals as directed by your caregiver. If a large amount of tube feedings are pulled back (aspirated) from the feeding tube, call your caregiver right away.

General guidelines to prevent aspiration include:

  • Feed small amounts of food. Do not force feed.

  • Use as little water as possible when brushing the person's teeth or cleaning his or her mouth.

  • Provide oral care before and after meals.

  • Never put food or fluids in the mouth of a person who is not fully alert.

  • Crush pills and put them in soft food such as pudding or ice cream. Some pills should not be crushed. Check with your caregiver before crushing any medication.


  • The person has trouble breathing or starts to breathe rapidly.

  • The person is breathing very slowly or stops breathing.

  • The person coughs a lot after eating or drinking.

  • The person has a chronic cough.

  • The person coughs up thick, yellow, or tan sputum.

  • The person has a fever or persistent symptoms for more than 72 hours.

  • The person has a fever and their symptoms suddenly get worse.