[95] Foreign Body Aspiration Flashcards

1
Q

What is foreign body aspiration?

A

The inhalation of a foreign body into the larynx and respiratory tract

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2
Q

When do most causes of foreign body aspiration in children occur?

A

In children aged 6 months - 3 years

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3
Q

Why do most cases of foreign body aspiration occur in children aged 6 months - 3 years?

A
  • Due to the tendency of small children to place objects in their mouth and nose
  • Most children of this age lack molars, and cannot grind up food into small pieces for proper swallowing
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4
Q

What are the risk factors for foreign body aspiration?

A
  • Age <4 years
  • Decreased consciousness
  • Bulbar dysfunction
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5
Q

What are the clinical features of foreign body aspiration?

A

Sudden onset of respiratory distress, associated with;

  • Gagging
  • Coughing
  • Stridor
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6
Q

What does unilateral wheezing suggest in foreign body aspiration?

A

Partial obstruction of main or distal bronchi

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7
Q

What is the initial imaging of choice in suspected foreign body aspiration?

A

CXR

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8
Q

Why is CXR the initial imaging of choice in suspected foreign body aspiration?

A

As radio-opaque foreign bodies can be visualised

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9
Q

What is the sensitivity of CXR for foreign body aspiration?

A

Around 20%

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10
Q

What other imaging modality can confirm foreign body aspiration?

A

Flexible bronchoscopy

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11
Q

Other than confirming the diagnosis, what else can flexible bronchoscopy be used for in foreign body aspiration?

A

Confirming the diagnosis

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12
Q

What can be performed if flexible bronchoscopy fails?

A

Rigid bronchoscopy

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13
Q

What are the differential diagnoses of foreign body aspiration?

A
  • Asthma exacerbation
  • Cystic fibrosis with exacerbation
  • Croup
  • Epiglottitis
  • Pneumonia
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14
Q

What is the treatment of foreign body aspiration determined by?

A

The severity of the obstruction of the airway involved

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15
Q

How can foreign body aspiration often be managed in partial obstruction?

A

The patient can usually be cleared by coughing

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16
Q

What is required in complete obstruction in foreign body aspiration?

A

Acute intervention

17
Q

What is the first line intervention in complete obstruction by foreign body?

A

Heimleich manoeuvre and back slaps

18
Q

What can be done if the Heimlich manoeuvre and back slaps do not clear the obstruction in foreign body aspiration?

A

Laryngoscopy with removal of the foreign body with forceps if it can be visualised

19
Q

What should be done if the foreign body cannot be visualised on laryngoscopy in foreign body aspiration?

A

Intubation, tracheotomy, or needle cricothyrotomy

20
Q

What is the initial imaging of choice in suspected foreign body aspiration?

A

CXR

21
Q

Why is CXR the initial imaging of choice in suspected foreign body aspiration?

A

As radio-opaque foreign bodies can be visualised

22
Q

What is the sensitivity of CXR for foreign body aspiration?

A

Around 20%

23
Q

What other imaging modality can confirm foreign body aspiration?

A

Flexible bronchoscopy

24
Q

Other than confirming the diagnosis, what else can flexible bronchoscopy be used for in foreign body aspiration?

A

Confirming the diagnosis

25
Q

What can be performed if flexible bronchoscopy fails?

A

Rigid bronchoscopy

26
Q

What are the differential diagnoses of foreign body aspiration?

A
  • Asthma exacerbation
  • Cystic fibrosis with exacerbation
  • Croup
  • Epiglottitis
  • Pneumonia
27
Q

What is the treatment of foreign body aspiration determined by?

A

The severity of the obstruction of the airway involved

28
Q

How can foreign body aspiration often be managed in partial obstruction?

A

The patient can usually be cleared by coughing

29
Q

What is required in complete obstruction in foreign body aspiration?

A

Acute intervention

30
Q

What is the first line intervention in complete obstruction by foreign body?

A

Heimleich manoeuvre and back slaps

31
Q

What can be done if the Heimlich manoeuvre and back slaps do not clear the obstruction in foreign body aspiration?

A

Laryngoscopy with removal of the foreign body with forceps if it can be visualised

32
Q

What should be done if the foreign body cannot be visualised on laryngoscopy in foreign body aspiration?

A

Intubation, tracheotomy, or needle cricothyrotomy