Which factor increases aspiration risk in head trauma/surgery patients?

• A. Fully awake
• B. Altered LOC
• C. Normal LOC
• D. Improved mental status

Answer: (B)

Consciousness level drives airway protection. When consciousness is altered, the brain’s control of swallow and cough/gag reflexes is depressed, so protective airway reflexes are blunted. In head trauma or after surgery, sedation, brain injury, or anesthesia can reduce these reflexes, making it easier for secretions, blood, or gastric contents to be aspirated, especially during induction, emergence, or periods of partial sedation. Being fully awake or maintaining normal/ improved mental status means these protective reflexes are more intact, which lowers the risk of aspiration. Therefore, altered level of consciousness is the factor that increases aspiration risk.