Following aspiration during a barium swallow test

Following aspiration during a barium swallow test

This advice sheet is for patients who have aspirated barium into the lungs during a barium swallow test or meal and is designed to accompany advice given by the Radiotherapist/Radiologist performing your procedure.

What does ‘Aspiration’ mean?

Aspiration is when something you swallow goes down the wrong way and enters your airway or lungs. Occasionally during the procedure, a patient will have difficulty swallowing the barium. As your oesophagus (gullet) is near the trachea (windpipe), the barium liquid may be inhaled, via the trachea, into the lungs.

How will I know if I have aspirated any barium?

The radiologist or specialist radiographer will know if you have aspirated the barium liquid whilst the investigation is being carried out. They will be able to see this happen on the special X-ray equipment during the procedure. You may also find that you want to cough naturally as the barium liquid will irritate your lungs.

What happens if I have aspirated some barium?

If you have aspirated some of the barium liquid into the lungs, it is usually only a small amount and can be cleared easily with a cough. It is important to clear your chest as soon as possible to prevent a chest infection developing.

How do I clear the barium from my lungs?

To do this, we use some special breathing techniques called the ‘Active Cycle of Breathing Technique’ (ACBT). These are simple breathing exercise which will help to improve the efficiency of your cough and help clear the barium from your lungs. Follow the 4 steps below: Or watch via this link (link to be added)

1. Breathing control

• Get into a comfortable position, with your shoulders and arms relaxed. Sitting upright or left side lying may be the best positions to use.
• Gently breathe in through your nose, (if possible) at a comfortable speed
• Breathe out through your mouth, at a comfortable speed
• You should feel your tummy softly moving in and out with your breathing
• Maintain this relaxed breathing for one to two minutes

2. Deep Breathing Exercises

• Take 3 – 4 long / slow / deep breaths in, through your nose to allow your lungs to fill as much as possible
• At the end of the breath in, hold the air in for 2-3 seconds
• Let the air out gently through your mouth at a comfortable speed
• Try to ensure neck and shoulders remain relaxed throughout
• Avoid rushing the next breath in as this may push secretions further down into your airways
• If you feel yourself going a bit dizzy, then stop and go back to breathing control.

3. Huffing

• Take a slow breath in through your nose, a little deeper than a normal breath, but not as large as during the deep breathing exercise above.
• Open your mouth to an ‘O’ shape and huff the air out, as if you are trying to steam up a mirror.
• The secretions should move upwards so that you can cough them up or perform a short, sharp huff to move them into your mouth.
• Limit the number of huffs to one or two to reduce the chance of becoming wheezy or starting a ‘coughing fit.’

4. Cough

• Only cough when you can hear phlegm when you huff.
• You may notice you cough up a white substance which is the barium.
• You should only cough if the sputum/barium can be cleared easily. It is particularly important to avoid long bouts of coughing as these can be very tiring and may make you feel breathless, or make your throat or chest sore or tight

If you feel secretions remain, wait a few minutes to catch your breath, then repeat stages 1-4 as required.

The Active Cycle of Breathing Technique Summary:

Your Radiographer/Radiologist will encourage you to do these exercises up to 4 times during the day, for the next 48hrs. They will advise you if there is a more beneficial position to complete these exercises in – for example lying on your left side.

You may also feel these exercises will be beneficial to do after meals or drinks to ensure your chest remains clear if food/drink continues to go down the wrong way.

What do I do if I feel unwell after I have aspirated?

If you develop any breathing difficulties or a cough, please seek medical advice, via your GP or 111 or if an emergency attend A&E or call 999.

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience

We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback

Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)

If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:

Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:

The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.  

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