Which action should be taken to prevent aspiration in a patient with preoperative NPO status during perioperative care?

• A. Maintain head of bed elevated, ensure swallowing safety, and implement aspiration precautions.
• B. Allow oral intake preoperatively.
• C. Place patient in steep Trendelenburg.
• D. Remove aspiration precautions.

Answer: (A)

Preventing aspiration hinges on protecting the airway during perioperative care. Keeping the head of the bed elevated reduces the chance that gastric contents regurgitate toward the oropharynx when airway reflexes are blunted during anesthesia. Verifying swallowing safety ensures the patient can protect their airway and minimizes the risk of aspiration from secretions or residual contents. Having aspiration precautions in place—such as suction equipment ready and appropriate patient positioning—provides a safety net to manage any event promptly. Actions that would allow oral intake despite NPO, worsen reflux risk by placing the patient in a position that promotes regurgitation, or remove safety measures would increase aspiration risk. So the best approach is to maintain head elevation, assess swallowing safety, and uphold aspiration precautions.