Case study: Asphyxia caused by inspissated oral and nasopharyngeal secretions.
An institutionalized man with severe mental disability and cerebral palsy, admitted from the ED with suspected aspiration pneumonia, died after a long struggle with respiratory difficulties. The cause of death was determined to be asphyxia resulting from a complete obstruction of the posterior pharynx and upper larynx by thickened oral and nasopharyngeal secretions. Although airway obstruction is common in people with motor or neurologic disorders and in those who are chronically debilitated or institutionalized, food and foreign matter are not the only culprits. This case serves to remind clinicians that a failure to provide good oral care and adequate hydration is not only poor practice but can result in death.
Prahlow
Joseph A
JA
South Bend Medical Foundation, Indiana University School of Medicine-South Bend at the University of Notre Dame, USA. jprahlow@sbmf.org
Prahlow
Tamara J
TJ
Rakow
Rex J
RJ
Prahlow
Nathan D
ND
D000402:Airway Obstruction / Q000209:etiology* / Q000517:prevention & control; D001237:Asphyxia / Q000209:etiology* / Q000517:prevention & control; D001344:Autopsy; D015984:Causality; D002423:Cause of Death; D002547:Cerebral Palsy / Q000150:complications; D003951:Diagnostic Errors; D006801:Humans; D008607:Intellectual Disability / Q000150:complications; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa; D009093:Mucus; D009297:Nasal Mucosa; D009910:Oral Hygiene / Q000451:nursing