Mendelson syndrome

Obstetrics

Clinicals - History

Fact Explanation
Asymptomatic Some patients may not present with any symptoms and they are known to have silent aspiration. Asymptomatic
Some patients may not present with any symptoms and they are known to have silent aspiration.
Symptoms of respiratory distress Patients with aspiration of gastric acid present with symptoms of respiratory distress within two to six hours of aspiration.
Shortness of breath, wheezing and cyanosis are common complains.
Symptoms of respiratory distress
Patients with aspiration of gastric acid present with symptoms of respiratory distress within two to six hours of aspiration.
Shortness of breath, wheezing and cyanosis are common complains.
Fever Some patients develop fever. Patients can develop fever in the presence of aspiration pneumonia as well. Fever
Some patients develop fever. Patients can develop fever in the presence of aspiration pneumonia as well.
Cough Coughing occurs secondary to acid aspiration. Cough
Coughing occurs secondary to acid aspiration.
Risk factors In addition to pregnancy, general anesthesia, obesity, and opioid analgesics increases the risk of Mendelson's syndrome. Risk factors
In addition to pregnancy, general anesthesia, obesity, and opioid analgesics increases the risk of Mendelson's syndrome.

Clinicals - Examination

Fact Explanation
Tachypnea Increased respiratory rate can be detected in affected patients. This usually develops two to six hours after aspiration. Tachypnea
Increased respiratory rate can be detected in affected patients. This usually develops two to six hours after aspiration.
Wheezing Aspiration of the gastric contents causes inflammation and subsequent edema of the airway. This results in wheezing. Wheezing
Aspiration of the gastric contents causes inflammation and subsequent edema of the airway. This results in wheezing.
Cyanosis Patients can develop cyanosis due to reduced oxygenation, as a result of respiratory distress. Cyanosis
Patients can develop cyanosis due to reduced oxygenation, as a result of respiratory distress.
Hypotension Respiratory distress can cause hypotension. Hypotension
Respiratory distress can cause hypotension.
Pulmonary edema Pulmonary crackles are indicative of pulmonary edema.
Reduced chest expansion, dull percussion note, increased tactile vocal fremitus and reduced breath sounds over the affected lobe are indicative of lobar consolidation in aspiration pneumonia, which is common over the lower lobe of the right lung.
Pulmonary edema
Pulmonary crackles are indicative of pulmonary edema.
Reduced chest expansion, dull percussion note, increased tactile vocal fremitus and reduced breath sounds over the affected lobe are indicative of lobar consolidation in aspiration pneumonia, which is common over the lower lobe of the right lung.

Investigations - Diagnosis

Fact Explanation
Chest X-ray Pulmonary edema is a recognized complication of Mendelson's syndrome.
In addition, if the patient has aspiration pneumonia, lobar consolidation can be seen commonly over the right lower lobe.
Chest X-ray
Pulmonary edema is a recognized complication of Mendelson's syndrome.
In addition, if the patient has aspiration pneumonia, lobar consolidation can be seen commonly over the right lower lobe.
Pulse oxymetry Pulse oxymetry shows reduced oxygen saturation. Pulse oxymetry
Pulse oxymetry shows reduced oxygen saturation.

Management - Supportive

Fact Explanation
Health education Patients who are awaiting surgery under general anesthesia should be clearly advised about the necessity of fasting for solids for six hours and two hours for liquids. Health education
Patients who are awaiting surgery under general anesthesia should be clearly advised about the necessity of fasting for solids for six hours and two hours for liquids.

Management - Specific

Fact Explanation
Airway management during anesthesia Airway protection with endotracheal intubation is indicated in every patient. Application of cricoid pressure during intubation is effective in minimizing the risk of Mendelson's syndrome. Maintaining the head end elevated is also helpful. Airway management during anesthesia
Airway protection with endotracheal intubation is indicated in every patient. Application of cricoid pressure during intubation is effective in minimizing the risk of Mendelson's syndrome. Maintaining the head end elevated is also helpful.
Acid prophylaxis Patients who are awaiting elective Cesarean section should be given acid prophylaxis at the time of induction of anesthesia.
Single dose of sodium citrate, and ranitidine are used for acid prophylaxis.
Acid prophylaxis
Patients who are awaiting elective Cesarean section should be given acid prophylaxis at the time of induction of anesthesia.
Single dose of sodium citrate, and ranitidine are used for acid prophylaxis.

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