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Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
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powdersFebruary 11 2015

A patient safety alert warning of potential choking hazards with powders used to thicken fluids and foodstuffs has been issued.

NHS England has issued the alert “to raise awareness of the need for proper storage and management of thickening powder used as part of the treatment of people with dysphagia (swallowing problems).”

Thickening agents can be added to foods and liquids to bring them to the right consistency or texture so they can be safely swallowed to provide required nutrition and hydration, says NHS England.

However, it has identified a couple of incidents where patients have come to harm as a result of accidentally swallowing thickening powder, when it had not been properly stored out of reach.

NHS England was made aware of a case where a “care home resident died following the accidental ingestion of the thickening powder that had been left within their reach. Whilst this death remains under investigation, it appears the powder formed a solid mass and caused fatal airway obstruction.”

In addition, the National Reporting and Learning System (NRLS) database carries a report of a similar happening in a hospital setting: “HCA alerted by another patient that the patient was choking. Found to have taken the lid off a tub of thickening powder and attempted to tip it back to ‘drink’. The patient is partially sighted and his condition fluctuates re conscious / alert levels. Thickener was a fresh tub today as trial re his poor swallow…”

NHS England is advising that “whilst it is important that products remain accessible, all relevant staff need to be aware of potential risks to patient safety.

“Appropriate storage and administration of thickening powder needs to be embedded within the wider context of protocols, bedside documentation, training programmes and access to expert advice required to safely manage all aspects of the care of individuals with dysphagia. Individualised risk assessment and care planning is required to ensure that vulnerable people are identified and protected.”

The prevalence of swallowing problems is not known, but it is estimated that dysphagia may occur in up to 30% of people aged over 65.

Links:

NHS England announcement    

Patient Safety Alert NHS/PSA/W/2015/002    

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