AIRWAY FOREIGN BODY

Question 1

Approach the the Critically Ill COMPLETE Foreign Body Aspiration

Answer 1

BLS

If fails direct laryngoscopy with extraction with MacGill forceps

If fails, orotracheal intubation with dislogement of FB distally

Emergent surgical airway

Question 2

Most common aspirated objects

Answer 2

Foods
Toys

Question 3

History & Physical

Answer 3

Sudden onset coughing or choking / gagging

Stridor and horseness - laryngotracheal area

+/-Unilateral wheezing and decreased breath sounds - bronchial

Concern by parent for aspiration

Question 4

Investigations

Answer 4

XRAY normal in > 50% tracheal FB, >25% of bronchial FB

> 75% of FB in children <3 yrs of age are radiolucent

Coin in trachea saggital

Coin in esophagus coronal

Atelectasis in complete obstruction

Hyperinflation of obstructed lung in expiration in partial obstruction

Bronchoscopy

Question 5

Management: Partial obstruction

Answer 5

Rigid bronchoscopy