The experience of vomitus entering the nasal passage requires immediate action. This happens because the soft palate fails to completely seal off the nasal cavity during vomiting. Since stomach contents are highly acidic, contact with the nasal lining can cause burning and irritation. A more serious concern is the potential for aspiration, where the material is accidentally inhaled into the lungs, which can result in a lung infection called aspiration pneumonia.
Safe Techniques for Immediate Clearance
The safest immediate response for an adult is to lean forward over a sink or basin, allowing gravity to encourage drainage. Gentle, controlled exhalation through the nose can help push the material out without forcing it deeper into the sinus cavities. Resist the urge to forcefully blow the nose, as this pressure can propel the gastric contents into the narrow passages connecting the nose to the middle ear, a process known as insufflation.
For an infant or small child, the approach must be gentler and focused on positioning. Immediately turn the child onto their stomach across your lap or place them on their side to allow the material to drain from the nose and mouth. If bulk material remains, use a soft bulb syringe or a nasal aspirator to gently suction the material from the nostrils. These tools are less likely to cause trauma or push the material further up the nasal cavity.
Once the bulk material is cleared, a saline nasal spray or drops can be used to flush out any acidic residue. The saline solution helps to neutralize the stomach acid and soothe the irritated mucous membranes. After applying the drops, you can gently use the aspirator again to remove the loosened fluid, but avoid excessive suctioning to prevent irritation. This gentle rinsing action reduces the risk of prolonged chemical irritation.
Monitoring and When to Call a Doctor
After the immediate clearance, it is important to monitor the individual for signs of persistent distress or potential complications. Watch closely for any continued difficulty breathing, wheezing, or a persistent cough that does not resolve quickly. These symptoms could indicate that some material has been aspirated into the lower airways, which requires medical attention.
Signs of distress, such as a change in skin color to blue or gray, particularly around the lips or fingernails, warrant an immediate call to emergency services. Any instance of vomiting accompanied by a headache, confusion, or a stiff neck requires a medical evaluation. These can be indicators of a more serious underlying health issue.
In the hours and days following the event, monitor for delayed signs of aspiration pneumonia, which can include a fever, shortness of breath, or a general feeling of lethargy. To aid in recovery and prevent dehydration, encourage small, frequent sips of clear liquids like water or oral rehydration solutions. If vomiting continues for more than 24 hours in a child under two, or 48 hours in an adult, medical consultation is recommended.