Foreign Body Aspiration

Question 1

Most common site of foreign body aspiration

Answer 1

Right bronchus

Question 2

Foreign body aspiration early presentation

Answer 2

Cough
Wheezing
Decreased breath sounds (usually on the right)

Question 3

Foreign body aspiration late presentation

Answer 3

Hypoxemia
Cyanosis
Altered mental status
Cardiac arrest

Question 4

Supraglottic obstruction vs subglottic obstruction presentation

Answer 4

Supraglottic obstruction: stridor
Subglottic obstruction: wheezing

Question 5

Foreign body aspiration surgical considerations

Answer 5

Rigid bronchoscopy (gold standard)
Flexible bronchoscopy or thoracotomy

Question 6

Rigid bronchoscopy complications

Answer 6

Laryngospasm
Bradycardia during scope insertion
Post-intubation croup
Pneumothorax

Question 7

Why is spontaneous ventilation preferred for foreign body retrieval?

Answer 7

It maintains laminar flow which reduces distal movement of the foreign body

Question 8

Why is it best to avoid PPV during foreign body retrieval?

Answer 8

PPV can push the object deeper into the bronchial tree

Question 9

Why might TIVA be preferred during a foreign body retrieval procedure?

Answer 9

Air leak during bronchoscopy may make it difficult to maintain adequate anesthetic depth; coughing/ bucking must be avoided to prevent distal movement of the foreign body