Key Points: Esophageal Atresia

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Esophageal Atresia

•“Atresia” means the absence of a normal body opening or the abnormal closure of a body passage.

•The esophagus ends in a blind pouch.

•Incidence is about 1 in 2500 births.

•This anomaly can cause respiratory distress.

•Clinical manifestations are:

–Mucus or fluids swallowed goes into the blind pouch.

–Overflows resulting in aspiration into trachea.

•Nursing care involves watching for:

–Frothy, excessive drooling.

–Periods of respiratory distress with choking and cyanosis.

–Do NOT feed the infant if Atresia is suspected.

Pre-operative care:

•High humidified air with oxygen.

•Elevate head and chest 30 degrees to prevent reflux of gastric juices.

•Constant observations for changes.

•Nasopharyngeal suction frequently.

•IV antibiotics.

•Change positions frequently.

•Support for the family.

Post-operative care:

•Constant observations for respiratory distress.

•Care for Gastrostomy tube site, with feedings beginning perhaps 2nd or 3rd day.

–Feed slowly.

–First feeding clear liquids (glucose water, Pedialyte).

•Frequent suctioning required.

•TLC need to be cuddled and held (pacifier may be used with tube feeding to satisfy sucking needs).

•Oral feeding may begin in 8 to 10 days.

•Encourage caregivers to participate in care.

•Home care—tube may be left in place for several months.

–Advise mother to discontinue feedings & consult MD if choking or regurgitation occur.