Jan 8, 2015 09:12
9 yrs ago
12 viewers *
Spanish term

vía área riesgo aspiración

Spanish to English Medical Medical: Health Care
This is included in a checklist for staff involved in surgery. What's the neatest way to say this in English? (It needs to be fairly short to fit in the table.) I'm assuming "área" should be "aérea". The list is from Argentina.

Discussion

Charles Davis Jan 9, 2015:
@Muriel No more room in the peer comment box.
If the expanded form is to be "at risk for aspiration", it isn't clearer; it's potentially misleading, as witness the fact that Carol misunderstood it and thought it meant aspiration (of air) being at risk. "Riesgo aspiración" undoubtedly means "riesgo de aspiración", the risk of aspiration, which doesn't mean breathing in but aspirating reflux or stomach contents and choking. "Aspiration risk" is a little shorter than "risk of aspiration", which is probably why surgical checklists use it, but it's certainly not ambiguous.
As I've said, I think the translation ought to reflect the fact that the question term refers to two different things: securing the airway and taking precautions to prevent aspiration or deal with it if it occurs.

Proposed translations

+2
11 mins
Selected

airway at risk for aspiration

Respiratory Care: Principles and Practice
https://books.google.com/books?isbn=076376003X
Neil MacIntyre, ‎Shelley Mishoe, ‎William Galvin - 2011 - ‎Medical
... carcinoma treated surgically or with radiation therapy; and uncontrolled airway at risk for aspiration (tube feeding or recent meal). Reverse Tren— delenburg is ...

Ch 40 Airway Clearance Therapy flashcards | Quizlet
quizlet.com/.../ch-40-airway-clearance-therapy-flash-cards/
Quizlet
I. head and neck injury (until stabilized) II. active hemorrhage with hemodynamic instability. III. uncontrolled airway at risk for aspiration. I. head and neck injury ...

Airway Clearance Techniques flashcards | Quizlet
quizlet.com/14519332/airway-clearance-techniques-flash-cards/
Quizlet
... gross hemoptysis related to lung carcinoma treated surgically or w/ radiation therapy. Uncontrolled airway at risk for aspiration (tube feeding or recent meal)∗.
Peer comment(s):

agree Carol Gullidge : as aspiration is the act of breathing (in), which is clearly a desirable function and not a danger, this is logically more likely to be a risk "for" rather than "of" aspiration
1 hr
Thanks so much, Carol!
agree Filippe Vasconcellos de Freitas Guimarães : Absolutely!
4 hrs
Thanks, Filippe!
neutral Emma Goldsmith : I don't think your suggestion is wrong, but Charles has found the exact terminology used in the WHO surgical safety checklist.
1 day 7 hrs
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4 KudoZ points awarded for this answer. Comment: "Selected automatically based on peer agreement."
+1
10 mins

airway / aspiration risk

The slash in my answer doesn't indicate alternatives; my suggestion is to use exactly that wording. "Risk of aspiration" would be perfectly OK for the second bit, of course.

"Surgical Safety Checklist
A simple checklist developed by the World Health Organisation which reduces surgical morbidity and mortality and sentinel events by such simple exercises as confirming the patient’s identity, site, procedure and consent, allergies, airway/aspiration risk, risk of blood loss, sponge counts, etc."
http://medical-dictionary.thefreedictionary.com/Surgical Saf...

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Note added at 14 mins (2015-01-08 09:26:09 GMT)
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"WA Health Surgical Safety Checklist [...]
Anaesthesia safety check
completed
(including airway/aspiration risk)"
http://www.health.wa.gov.au/circularsnew/attachments/529.pdf

"SCOAP
Surgical Checklist Initiative
[...]
" Anesthesia Machine Ready
 Patient Position
 Airway/aspiration risk assessment completed"
http://www.scoap.org/downloads/SCOAP-Surgical-Checklist_v3_4...

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Note added at 19 mins (2015-01-08 09:31:29 GMT)
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In other words, I think it means that one of the things that must be done is to check the airway and specifically check for risk of pulmonary aspiration.

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Note added at 1 hr (2015-01-08 10:36:55 GMT)
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It's quite commonly expressed as "Difficult airway / aspiration risk", including in the WHO list:
http://www.who.int/patientsafety/safesurgery/tools_resources...

So you could add "difficult" before this, but I don't think it's necessary, and after all it doesn't say that in your original.

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Note added at 5 hrs (2015-01-08 14:43:47 GMT)
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I'm really quite sure that it means risk of aspiration; that is, that there is a risk of aspiration, which doesn't mean breathing air into the lungs (a good thing) but aspirating material:

"Pulmonary aspiration is the entry of material (such as pharyngeal secretions, food or drink, or stomach contents) from the oropharynx or gastrointestinal tract into the larynx (voice box) and lower respiratory tract (the portions of the respiratory system from the trachea — i.e., windpipe — to the lungs)."
http://en.wikipedia.org/wiki/Pulmonary_aspiration

As I think I've shown already, this is an item commonly included on surgery checklists, following the WHO model, and it refers to two separate checks: (a) difficult airway? and (b) aspiration risk? – two separate elements. Here is the full WHO explanation of this item:

"Does the patient have a difficult airway/aspiration risk?
The Checklist coordinator should verbally confirm that the anaesthesia team has objectively assessed whether the patient has a difficult airway. There are a number of ways to grade the airway (such as the Mallampati score, thyromental distance, or Bellhouse-Doré score). An objective evaluation of the airway using a valid method is more important than the choice of method itself. Death from airway loss during anaesthesia is still a common disaster globally but is preventable with appropriate planning. If the airway evaluation indicates a high risk for a difficult airway (such as a Mallampati score of 3 or 4), the anaesthesia team must prepare against an airway disaster. This will include, at a minimum, adjusting the approach to anaesthesia (for example, using a regional anaesthetic, if possible) and having emergency equipment accessible. A capable assistant—whether a second anaesthetist, the surgeon, or a nursing team member—should be physically present to help with induction of anaesthesia.
The risk of aspiration should also be evaluated as part of the airway assessment. If the patient has symptomatic active reflux or a full stomach, the anaesthetist must prepare for the possibility of aspiration. The risk can be reduced by modifying the anaesthesia plan, for example using rapid induction techniques and enlisting the help of an assistant to provide cricoid pressure during induction. For a patient recognized as having a difficult airway or being at risk for aspiration, induction of anaesthesia should begin only when the anaesthetist confirms that he or she has adequate equipment and assistance present at the bedside."
http://www.ncbi.nlm.nih.gov/books/NBK143244/

So although "at risk for aspiration" can be said, the "airway" part is separate. It's not just a question of whether the airway is at risk for aspiration; the airway is an item in its own right.

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Note added at 5 hrs (2015-01-08 14:46:58 GMT)
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And just to confirm, here's the WHO (OMS) recommendation in Spanish. They have omitted "difícil", perhaps for reasons of space:

"¿Tiene el paciente...
... Alergias conocidas?
No

… Vía aérea difícil / riesgo de aspiración?
No
Sí, y hay instrumental y equipos / ayuda disponible"
http://whqlibdoc.who.int/publications/2009/9789243598598_spa...
Peer comment(s):

neutral Muriel Vasconcellos : Carol made a good point. The 'for' is needed. I think we're saying that the expanded form is clearer. It's not a big deal. Maybe this comment belongs in the Discussion, rather than here, but I wanted to explain why I withdrew my Agree.
10 hrs
No, absolutely not! Carol misunderstood. It refers to preventing aspiration of reflux, not ensure aspiration of air. See para. 2 of long ref. in added note, and "riesgo de aspiración" in last ref. ("At risk for aspiration" in your own ref. means this too)
agree Emma Goldsmith : As you point out, it should be "difficult airway or aspiration risk" as per the WHO checklist.
1 day 7 hrs
Many thanks, Emma. Happy New Year :)
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Reference comments

1 day 7 hrs
Reference:

WHO surgical safety checklist

The Spanish phrase is almost exactly what is used in the official WHO translation:
¿Tiene el paciente [...] vía aérea difícil / riesgo de aspiración?

So, the English original should be used here.

Charles provided the link to the WHO checklist in his answer, and I discussed it here a couple of years ago:
http://signsandsymptomsoftranslation.com/2012/11/22/checklis...
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