Inhaled foreign obejct + intestinal obstruciton Flashcards
How patietns present with a foreign object?
Acute onset cough
Chest pain
SOB
Subacyte unexpplained haemoptysis
Non resolving pneumonia
Incidental finding on imaging
What do inhaled foreign objects cuase?
Gagging, choking, distress - as pass epiglottis and vocal cords
What do tracheal foregin bodies cause?
Asthmatoid wheeze, audible slap from ribbed trachea, palpable thud
What syndome characterises endocbronchial bodies
Penetration syndrome - choking and irritable cough followed by vomitting
What is penetration syndrome?
choking and irritable cough followed by vomitting
What are features of mild obstruction from inhalfed foregin object?
Breathe, cough and speak
Fully responseive, cry/verbal, loud cough
Severe obstruction indications
Victim unable to breathe, cough effectively and speak
Wheezy breath sounds
Attemots at coughing that are quiet or silent
Cyanosis and diminsihing LOC
VUnconscious
Risks for choking
Old age
Poor dentition
Alcohol consumption
Chronic disease
Sedation
Eating risky foods
Management of choking in a child
- 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
What to do if child becomes unconscious and was choking?
Falt, firm surgaev, shout for help again
Open mouth and look - single finer sweep
Paeds BLS - 5 rescur bbreaths
Adult choking treatment and management
Encourage cough
5 back blows (leaning forwards)
5 abdominal thrusts
Continue until clear or become unconscious
999 + CPR
Complications directly from inhaled foreign body
Foreign material -> bronchiectasis or lung abscess
Who should be referred to A+E after inhalation of a foreign object?
Persistent cough
Difficulty swallowing
Sensation of object still stuck in throat
Hypoxic brain injury and death
How can a foreign obejcts be identified and removed?
CXR ->
Bronchoscopy as early as possible
What is atelectasis?
Collapsed lung
Iatrogenic complications from inhaled foreign body?
Abdominal thrusts can cause serious injuries eg gastric or splenic rupture
All require abdo inspection after thrusts
Iatrogenic complications from inhaled foreign body?
Abdominal thrusts can cause serious injuries eg gastric or splenic rupture
All require abdo inspection after thrusts
What is intestinal obstruction?
Physical obstruction prevents flow of faeces through the intestines -> back pressure through GI
What is absolute constipation?
Unable to pass stool or wind
Causes of intestinal obstruction
Meconium ileus
hirschprungs disease
Oesophageal atresia
Duodenal atresia
Intussception
Imperforate anus
Malrotation of the intestines with a volvulus
Strangulated hernia
Presentation of intestinal obstruction
Persistentvomitting - bilious (green)
Abdo pain and distension
Failure to pass stools or wind
Abnormal bowel sounds - high pitched and tinkling -> absent
Initial investigation for intestinal obstruction
Abdominal xray
What will show on an abdo xray on an xray
Dilated loops of bowel proximal
Collapsed loops of bowel distal
to obstruction
Absence of air in rectum
Management intestinal obstruction
Paediatric surgical unit as an emergency
Nil by mouth
Inserting NG tibe to drain stomach
IV fluids - correct dehydration and eletrolyte umbalances
