Inhaled foreign body

Question 1

Foreign body in the larynx or trachea can cause:

Answer 1

=> stridor
=> voice change 
=> choking
=> cyanosis
=> difficulty breathing
=> tachypnoea
=> pneumonia

Question 2

Where do most inhaled foreign bodies get stuck?

Who does it occur in?

Answer 2

Most inhaled foreign bodies enter the trachea and become lodged in the right main bronchus (straighter, wider path vs left bronchus).

Commonly occurs in young children, children with ADHD and adults with neurodevelopment disorders.

Question 3

How are foreign bodies at the laryngeal inlet removed?

Answer 3

Anaesthetic laryngoscope and Magill forceps

Question 4

How are inhaled foreign bodies in the trachea removed?

Answer 4

Formal paediatric bronchoscopy

Question 5

Incidence of button battery inhalation is increasing in children.

When the button battery is lodged, contact with the body tissue completes a circuit and allows a current to flow.

Electrical current from the battery results in generation of hydroxide radicals => electrochemical burn to the area.

Answer 5

Electrochemical burn to the area results in tissue necrosis, fistula and perforation through septum.

=> presents with purulent discharge, epistaxis and tissue necrosis can lead to black discharge, facial swelling, pain and fever

=> this can happen very quickly and be life threatening

=> emergency removal required immediately

=> radiological hallmark: small circular radio-opaque object with a ‘halo’ or a ‘double ring’, which represents small bevelled indentation around the edge of battery.

Question 6

What is the choking protocol for a child?

Answer 6

5x backslaps

followed by..

5 abdominal thrusts

Question 7

Objects found in the nose can be organic (food/bugs) or inorganic (nails, paper, stones).

Common organic objects:

Answer 7

1. Organic objects can cause:
   => local inflammatory reactions
   => secondary infections leading to sinusitis
   => present with unilateral purulent & foul-smelling discharge, nasal obstruction and facial pain from sinusitis.
2. Inorganic objects tend to be asymptomatic unless they are large to cause nasal obstruction