Schmitt M F, Hewer W
Psychiatrische Klinik am Zentralinstitut für Seelische Gesundheit, Mannheim.
Fortschr Neurol Psychiatr. 1993 Sep;61(9):313-8. doi: 10.1055/s-2007-999100.
Five cases of life-threatening bolus aspiration are described. Four patients could be rescued; an 48 year old woman died of an reflectoric bolus death, also called "cafe coronary". A review of the literature and the special conditions of our examples allow to define different predisposing factors for bolus aspiration: severe psychiatric illness, abnormal eating behaviour, local or spread brain lesions, dysphagia, old age, multimorbidity and newly institutionalised persons. Possible risk exacerbations by psychotropic drugs are discussed. The special threat to psychiatric patients is shown. Prevention of these dangerous situations consists of an individual dysphagia risk screening and of following certain rules concerning eating and medication. All staff members in psychiatric hospitals should be trained in life-saving techniques in bolus incidents.
本文描述了5例危及生命的团块误吸病例。4例患者获救；一名48岁女性死于反射性团块死亡，也称为“咖啡冠心病”。通过对文献的回顾以及我们案例的特殊情况，可以确定团块误吸的不同诱发因素：严重精神疾病、异常进食行为、局部或广泛性脑损伤、吞咽困难、老年、多种疾病以及新入住机构的人员。文中讨论了精神药物可能加剧的风险。展示了对精神病患者的特殊威胁。预防这些危险情况包括进行个体吞咽困难风险筛查以及遵循有关饮食和用药的某些规则。精神病医院的所有工作人员都应接受团块事件救生技术的培训。
