Inhaled foreign obejct + intestinal obstruciton

Question 1

How patietns present with a foreign object?

Answer 1

Acute onset cough
Chest pain
SOB
Subacyte unexpplained haemoptysis
Non resolving pneumonia
Incidental finding on imaging

Question 2

What do inhaled foreign objects cuase?

Answer 2

Gagging, choking, distress - as pass epiglottis and vocal cords

Question 3

What do tracheal foregin bodies cause?

Answer 3

Asthmatoid wheeze, audible slap from ribbed trachea, palpable thud

Question 4

What syndome characterises endocbronchial bodies

Answer 4

Penetration syndrome - choking and irritable cough followed by vomitting

Question 5

What is penetration syndrome?

Answer 5

choking and irritable cough followed by vomitting

Question 6

What are features of mild obstruction from inhalfed foregin object?

Answer 6

Breathe, cough and speak
Fully responseive, cry/verbal, loud cough

Question 7

Severe obstruction indications

Answer 7

Victim unable to breathe, cough effectively and speak
Wheezy breath sounds
Attemots at coughing that are quiet or silent
Cyanosis and diminsihing LOC
VUnconscious

Question 8

Risks for choking

Answer 8

Old age
Poor dentition
Alcohol consumption
Chronic disease
Sedation
Eating risky foods

Question 9

Management of choking in a child

Answer 9

• Encourage cough
• Call for help
• 5 back blows
• 5 abdominal thrusts or chest thrusts
• Repeat until clear or unconscious
  For infants (<1 year old) - back blows and chest thrusts:
• For children (1 year old to puberty) - back blows and abdominal

Question 10

What to do if child becomes unconscious and was choking?

Answer 10

Falt, firm surgaev, shout for help again
Open mouth and look - single finer sweep
Paeds BLS - 5 rescur bbreaths

Question 11

Adult choking treatment and management

Answer 11

Encourage cough
5 back blows (leaning forwards)
5 abdominal thrusts
Continue until clear or become unconscious
999 + CPR

Question 12

Complications directly from inhaled foreign body

Answer 12

Foreign material -> bronchiectasis or lung abscess

Question 13

Who should be referred to A+E after inhalation of a foreign object?

Answer 13

Persistent cough
Difficulty swallowing
Sensation of object still stuck in throat
Hypoxic brain injury and death

Question 14

How can a foreign obejcts be identified and removed?

Answer 14

CXR ->
Bronchoscopy as early as possible

Question 15

What is atelectasis?

Answer 15

Collapsed lung

Question 16

Iatrogenic complications from inhaled foreign body?

Answer 16

Abdominal thrusts can cause serious injuries eg gastric or splenic rupture
All require abdo inspection after thrusts

Question 16

Iatrogenic complications from inhaled foreign body?

Answer 16

Abdominal thrusts can cause serious injuries eg gastric or splenic rupture
All require abdo inspection after thrusts

Question 17

What is intestinal obstruction?

Answer 17

Physical obstruction prevents flow of faeces through the intestines -> back pressure through GI

Question 18

What is absolute constipation?

Answer 18

Unable to pass stool or wind

Question 19

Causes of intestinal obstruction

Answer 19

Meconium ileus
hirschprungs disease
Oesophageal atresia
Duodenal atresia
Intussception
Imperforate anus
Malrotation of the intestines with a volvulus
Strangulated hernia

Question 20

Presentation of intestinal obstruction

Answer 20

Persistentvomitting - bilious (green)
Abdo pain and distension
Failure to pass stools or wind
Abnormal bowel sounds - high pitched and tinkling -> absent

Question 21

Initial investigation for intestinal obstruction

Answer 21

Abdominal xray

Question 22

What will show on an abdo xray on an xray

Answer 22

Dilated loops of bowel proximal
Collapsed loops of bowel distal
to obstruction
Absence of air in rectum

Question 23

Management intestinal obstruction

Answer 23

Paediatric surgical unit as an emergency
Nil by mouth
Inserting NG tibe to drain stomach
IV fluids - correct dehydration and eletrolyte umbalances