LIFE - THREATENING SITUATIONS THROUGH BOL US ASPIRATION IN PSYCHIATRIC-INPATIENTS - CLINIC, RISK-FACTORS, PREVENTION, TREATMENT

Five cases of life-threatening bolus aspiration are described. Four pa tients could be rescued; an 48 year old woman died of an reflectoric b olus death, also called ''cafe coronary''. A review of the literature and the special conditions of our examples allow to define different p redisposing factors for bolus aspiration: severe psychiatric illness, abnormal eating behavior, local or spread brain lesions, dysphagia, ol d age, multimorbidity and newly institutionalised persons. Possible ri sk exacerbations by psychotropic drugs are discussed. The special thre at to psychiatric patients is shown. Prevention of these dangerous sit uations consists of an individual dysphagia risk screening and of foll owing certain rules concerning eating and medication. All staff member s in psychiatric hospitals should be trained in life-saving techniques in bolus incidents.