Can infants aspiration

Because the majority of vaccines have a similar appearance after being drawn into a syringe, prefilling might result in administration errors. Because unused prefilled syringes also typically must be discarded if not used within the same day that they are filled, vaccine wastage might occur.

The FDA does not license administration syringes for vaccine storage. In certain circumstances in which a single vaccine type is being used e. The doses should be administered as soon as possible after filling, by the same person who filled the syringes. Unused syringes that are prefilled by the manufacturer and activated i. Vaccine from two or more vials should never be combined to make one or more doses.

This can lead to violation of expiration dates and product contamination 6,7. Providers are sometimes concerned when they have the same contraindications or precautions as their patients from whom they withhold or defer vaccine.

For administration of routinely recommended vaccines, there is no evidence of risk of exposure of vaccine components to the health care provider, so conditions in the provider labeled as contraindications and precautions to a vaccine components are not a reason to withdraw from this function of administering the vaccine to someone else. Historic concerns about exposure to vaccine components are limited to non-parenteral vaccines in which some degree of environmental exposure is unavoidable 5, 8 , or situations in which self-inoculation is likely due to the nature of the vaccine microbe [e.

Persons administering ACAM smallpox vaccine to laboratory and health care personnel at risk for occupational exposure to orthopoxviruses can decrease the risk for inadvertent infection through recommended infection prevention measures. However, because of a theoretical risk for infection, vaccination with ACAM can be offered to health care personnel administering this vaccine, provided individual persons have no specified contraindications to vaccination Needles and syringes used for vaccine injections must be sterile and disposable.

A separate needle and syringe should be used for each injection. Changing needles between drawing vaccine from a vial and injecting it into a recipient is not necessary unless the needle has been damaged or contaminated Bloodborne diseases e. The Needlestick Safety and Prevention Act 2 was enacted in to reduce the incidence of needlestick injury and the consequent risk for bloodborne diseases acquired from patients. The act directed OSHA to strengthen its existing bloodborne pathogen standards.

The revised standards became effective in 2. These federal regulations require the use of engineering and work practice controls to eliminate or minimize employee exposure to bloodborne pathogens external icon.

Engineering controls means controls e. Needle-shielding or needle-free devices that might satisfy the occupational safety regulations for administering injectable vaccines are available in the United States The regulations also require maintenance of records documenting injuries caused by needles and other medical sharp objects and that nonmanagerial employees be involved in the evaluation and selection of safety-engineered devices before they are procured.

Additional information about implementation and enforcement of these regulations is available from OSHA. To prevent inadvertent needlestick injury or reuse, safety mechanisms should be deployed after use and needles and syringes should be discarded immediately in labeled, puncture-proof containers located in the same room where the vaccine is administered 5. Used needles should never be recapped. Routes of administration are recommended by the manufacturer for each immunobiologic Table Deviation from the recommended route of administration might reduce vaccine efficacy or increase the risk for local adverse reactions The method of administration of injectable vaccines is determined, in part, by the inclusion of adjuvants in some vaccines.

An adjuvant is a vaccine component distinct from the antigen that enhances the immune response to the antigen, but might also increase risk of adverse reactions. To decrease risk of local adverse events, inactivated vaccines containing an adjuvant should be injected into a muscle.

Administering a vaccine containing an adjuvant either subcutaneously or intradermally can cause local irritation, induration, skin discoloration, inflammation, and granuloma formation. Injectable immunobiologics should be administered where local, neural, vascular, or tissue injury is unlikely. Use of longer needles has been associated with less redness or swelling than occurs with shorter needles because of injection into deeper muscle mass Appropriate needle length depends on age and body mass.

Injection technique is the most important parameter to ensure efficient intramuscular vaccine delivery. For all intramuscular injections, the needle should be long enough to reach the muscle mass and prevent vaccine from seeping into subcutaneous tissue, but not so long as to involve underlying nerves, blood vessels, or bone 15, Vaccinators should be familiar with the anatomy of the area into which they are injecting vaccine. Intramuscular injections are administered at a degree angle to the skin, preferably into the anterolateral aspect of the thigh or the deltoid muscle of the upper arm, depending on the age of the patient Table The needle gauge for intramuscular injection is gauge.

A decision on needle length and site of injection must be made for each person on the basis of the size of the muscle, the thickness of adipose tissue at the injection site, the volume of the material to be administered, injection technique, and the depth below the muscle surface into which the material is to be injected Figure 1.

If the subcutaneous and muscle tissue are bunched to minimize the chance of striking bone 19 , a 1-inch needle or larger is required to ensure intramuscular administration.

Aspiration before injection of vaccines or toxoids i. For the majority of infants, the anterolateral aspect of the thigh is the recommended site for injection because it provides comparatively larger muscle mass than the deltoid Figure 2 In certain circumstances e. If the gluteal muscle must be used, care should be taken to define the anatomic landmarks. For toddlers, the anterolateral thigh muscle is preferred, and when this site is used, the needle should be at least 1 inch long.

The deltoid muscle can be used if the muscle mass is adequate. If 2 vaccines are to be administered in a single limb, they should be spaced an inch apart 4 , The anterolateral thigh can also be used In this case the needle length should be 1 inch to 1.

Knowledge of body mass can be useful for estimating the appropriate needle length The deltoid muscle is preferred for adolescents years of age. The anterolateral thigh can also be used. But in some cases, food or drink can enter the trachea. It may go down as your child swallows. Or it may come back up from the stomach. A child with dysphagia is much more likely to aspirate.

A child with a developmental or health problem is more likely to have dysphagia. Aspiration can happen during a feeding or meal. And it can happen after a feeding or meal. This is common in babies and children with certain health conditions. Aspiration can also happen at any time when your child swallows saliva.

If your child aspirates a small amount of material, it may not cause much harm. It can happen when eating, sleeping, or talking. But aspiration that happens often or in a large amount can be serious. Aspiration is often caused by dysphagia. Different medical conditions can lead to this, such as:. Gastroesophageal reflux disease GERD can also cause aspiration.

Signs and symptoms can happen right after eating. Or they may happen over time. Your child may not have all of these signs and symptoms. The signs and symptoms may depend on the age of your child, and how often and how much your child aspirates. This may be done by a speech-language pathologist SLP. They may want to watch your child during a feeding. Your child may also need tests. The tests may include:. Treatment for aspiration may vary depending on the cause and severity.

Treatments for your child may include:. If your child still has a high risk of aspiration despite these methods, they may need a special tube to help with eating for a while. The feeding tube will help your child get good nutrition until their risk of aspiration improves. Your child will not eat or drink normally until the tube is removed. A thin tube may be put through the nose down into the stomach. This is called a nasogastric tube. As the baby takes the first breaths at delivery, meconium particles enter the airway and can be aspirated inhaled deep into the lungs.

Meconium is passed into the amniotic fluid in about 10 percent of births. It usually occurs in babies born at term 37 to 41 weeks or post-term after 42 weeks.

Meconium particles in the amniotic fluid can block small airways and prevent the exchange of oxygen and carbon dioxide after birth. Some babies have immediate respiratory distress and have to be resuscitated at birth. Others develop respiratory distress within a few hours. Some babies with meconium aspiration need a mechanical ventilator breathing machine because of the difficulty breathing.

The plugged airways may cause air to be trapped and leak into the tissues in and around the lungs. Infection can also occur causing pneumonia.

Although the condition often improves within a few days, severe meconium aspiration, and the respiratory problems it causes, may lead to death in a small number of babies. Meconium in the amniotic fluid gives the fluid a greenish color. This is called meconium staining. Babies who have been exposed to meconium in the amniotic fluid for a long time may have yellowed skin and nails.