What should a respiratory therapist do if a patient receiving non-invasive ventilatory support is suspected of having aspirated?

When a patient receiving non-invasive ventilatory support is suspected of having aspirated, the appropriate action is to institute invasive mechanical ventilation. This is crucial because aspiration can lead to aspiration pneumonia, respiratory distress, and further complications that may rapidly worsen the patient’s status. Non-invasive ventilation may not be sufficient to ensure adequate oxygenation and ventilation, especially if the patient exhibits signs of significant respiratory compromise. Invasive mechanical ventilation provides better control of airway management and is necessary to manage the complications of aspiration effectively.

Shifting to a nasal mask may not address the underlying problem and could lead to further respiratory compromise. Continuing therapy with monitoring without addressing the potential need for more intensive support may allow the patient's condition to deteriorate. Bronchoalveolar lavage, while useful in certain situations, is not the first-line response for suspected aspiration during non-invasive support and could further compromise the patient’s stability when immediate respiratory support is needed.