Foreign Bodies Flashcards
How would you manage a foreign body in the ear or nose
Not an emergency unless foreign body is a watch battery
If watch battery - remove immediately
If live animal - remove next day in urgent clinic
Swallowed foreign body management
Remove foreign body immediately
Airway obstruction aetiology
Inflammatory/ infective/ allergic
foreign body/ tumour/ physical compression
Burns/ trauma/ neurological
Airway obstruction symptoms & signs
SOB, choking, coughing
Sternal/subcostal recession, tracheal tug
Cyanosis, dusky skin colour, pyrexia
Stridor or stertor
Airway obstruction initial treatment
- ABC resuscitation
- High flow oxygen/heliox (79% helium and 21% oxygen)
- Nebulised budesonide 2mg
- Dexamethasone 0.15-0.6 mg/kg
- Nebulised adrenaline 1:10000 (5ml)
- Call for help (anaesthetics)
OSA - oxygen, steroids (x2), adrenaline
Airway obstruction definitive treatment
Secure airway (1st line ET tube, 2nd line tracheostomy)
Flexible endoscopy (identify cause)
Treat cause
Supraglottitis vs epiglottitis
Supraglottitis - inflammation of upper larynx, includes epiglottitis!
Epiglottitis - specific to inflammation of epiglottis
Supraglottitis treatment
Treat for airway obstruction
Broad spectrum antibiotics
Call for senior help
Define Stridor
high-pitched harsh inspiratory noise due to turbulent airflow resulting from upper airway obstructions (around the voice box/ larynx)
Define stertor
low-pitched sonorous sound arising from nasopharyngeal airway (around the soft palate/tonsils/ tongue base)
Stridor vs stertor vs wheezing
Stridor - high pitch, inspiratory, larynx/ upper airway
Stertor - low pitch, inspiratory, nasopharyngeal
Wheezing - high pitch, expiration, trachea/bronchi
If a patients presents with signs of sepsis with voice change or airway symptoms but normal tonsils what is the likely diagnosis
Supraglottitis
