Which of the following is a major risk factor for aspiration?

• A. Tracheal intubation
• B. Vomiting
• C. Neuromuscular disease
• D. Prolonged supine positioning

Answer: (A)

The risk to protect the airway is the key idea. When tracheal intubation is used, the patient is typically under anesthesia or deep sedation, so normal swallowing and coughing reflexes are blunted and the airway is not fully protected. If regurgitation or gastric contents occur during induction, emergence, or around the cuff seal, material can enter the trachea and lungs. While the tube is intended to protect the airway, it does not guarantee zero aspiration risk, and the period around intubation represents a high-risk window for aspiration compared with the other scenarios listed.