Immediate care after aspiration of vomit

The diagnosis of aspiration can be made from the characteristic clinical features. Management is then based on the measurement of the pH of the gastric contents, blood gases and acid-base values, the serial measurement of pulse blood pressure and central venous pressure, and the haemoglobin and haematocrit. If available measurement of the plasma or blood volume, pulmonary artery and wedge pressure and cardiac output may also be of value in diagnosis and guiding treatment. The following treatment should be carried out: Head down in right lateral position to drain vomit from airway. Suction. Laryngoscopy to clear the airway. Bronchoscophy if asphyxiated by solid material. Endotracheal intubation if liquid. High inspired oxygen. Artificial ventilation if the PO2 is low. Steroids Hydrocortisone 200 mg intravenously and 100 mg intramuscularly every 6 hours; or Dexamethasone 10 mg intravenously and 5 mg intramuscularly every 6 hours. Aminophylline if bronchospasm is severe. Plasma or plasma substitute for hypotension and hypovolaemia. Correct acidosis.