Aspirated foreign body - Revision history

Rossdonaldson1: /* Background */

2022-04-23T12:02:50Z

Background

← Revisión anterior		Revisión del 12:02 23 abr 2022
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	*Consider in any child with respiratory symptoms		*Consider in any child with respiratory symptoms
	*Object can be lodged in upper airway (20% of cases) or bronchus (80%)		*Object can be lodged in upper airway (20% of cases) or bronchus (80%)

			{{FB types}}

	==Clinical Features==		==Clinical Features==

2021-09-25T12:21:22Z

Evaluation

← Revisión anterior		Revisión del 12:21 25 sep 2021
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	==Evaluation==		==Evaluation==
	~~[[File:Foreign body aspiration.jpg\|thumb\|Foreign body aspiration of a coin in the esophagus..]]~~
	[[File:Obstructive pneumonia Case 233 (7471755378).jpg\|thumb\|[[Chest x-ray]] of an adult with obstructive pneumonia in the right lung evidenced by hypodense area. This is from a blockage in the respiratory tract leading to an infection distal to the obstruction.]]		[[File:Obstructive pneumonia Case 233 (7471755378).jpg\|thumb\|[[Chest x-ray]] of an adult with obstructive pneumonia in the right lung evidenced by hypodense area. This is from a blockage in the respiratory tract leading to an infection distal to the obstruction.]]
	[[File:Aspiration pneumonia201711-3264.jpg\|thumb\|CXR showing focal pneumonia in lower right lung lobe classic for aspiration.]]		[[File:Aspiration pneumonia201711-3264.jpg\|thumb\|CXR showing focal pneumonia in lower right lung lobe classic for aspiration.]]

2021-09-25T12:20:44Z

Evaluation

← Revisión anterior		Revisión del 12:20 25 sep 2021
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	[[File:Foreign body aspiration.jpg\|thumb\|Foreign body aspiration of a coin in the esophagus..]]		[[File:Foreign body aspiration.jpg\|thumb\|Foreign body aspiration of a coin in the esophagus..]]
	[[File:Obstructive pneumonia Case 233 (7471755378).jpg\|thumb\|[[Chest x-ray]] of an adult with obstructive pneumonia in the right lung evidenced by hypodense area. This is from a blockage in the respiratory tract leading to an infection distal to the obstruction.]]		[[File:Obstructive pneumonia Case 233 (7471755378).jpg\|thumb\|[[Chest x-ray]] of an adult with obstructive pneumonia in the right lung evidenced by hypodense area. This is from a blockage in the respiratory tract leading to an infection distal to the obstruction.]]
			[[File:Aspiration pneumonia201711-3264.jpg\|thumb\|CXR showing focal pneumonia in lower right lung lobe classic for aspiration.]]
	*[[CXR]]		*[[CXR]]
	**Useful to confirm diagnosis, does not rule out		**Useful to confirm diagnosis, does not rule out

2021-09-25T12:16:21Z

Evaluation

← Revisión anterior		Revisión del 12:16 25 sep 2021
Línea 21:		Línea 21:

	==Evaluation==		==Evaluation==
			[[File:Foreign body aspiration.jpg\|thumb\|Foreign body aspiration of a coin in the esophagus..]]
	[[File:Obstructive pneumonia Case 233 (7471755378).jpg\|thumb\|[[Chest x-ray]] of an adult with obstructive pneumonia in the right lung evidenced by hypodense area. This is from a blockage in the respiratory tract leading to an infection distal to the obstruction.]]		[[File:Obstructive pneumonia Case 233 (7471755378).jpg\|thumb\|[[Chest x-ray]] of an adult with obstructive pneumonia in the right lung evidenced by hypodense area. This is from a blockage in the respiratory tract leading to an infection distal to the obstruction.]]
	*[[CXR]]		*[[CXR]]

2021-09-25T12:09:11Z

Evaluation

← Revisión anterior		Revisión del 12:09 25 sep 2021
Línea 21:		Línea 21:

	==Evaluation==		==Evaluation==
			[[File:Obstructive pneumonia Case 233 (7471755378).jpg\|thumb\|[[Chest x-ray]] of an adult with obstructive pneumonia in the right lung evidenced by hypodense area. This is from a blockage in the respiratory tract leading to an infection distal to the obstruction.]]
	*[[CXR]]		*[[CXR]]
	**Useful to confirm diagnosis, does not rule out		**Useful to confirm diagnosis, does not rule out

2019-09-30T17:05:50Z

← Revisión anterior		Revisión del 17:05 30 sep 2019
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	*[[Cough]], gagging		*[[Cough]], gagging
	*[[Stridor]], [[dysphonia]] (if stuck at level of larynx)		*[[Stridor]], [[dysphonia]] (if stuck at level of larynx)
	*Wheezing, decreased breath sounds (If lower airway)		*[[Wheezing]], decreased breath sounds (If lower airway)
	**Wheezing not responsive to bronchodilators		**Wheezing ''not'' responsive to [[bronchodilators]]
	*[[Fever]], [[pneumonia]] symptoms if retained		*[[Fever]], [[pneumonia]] symptoms if retained

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	*If unable to intubate, may need cricothyrotomy (though will not help if obstruction distal to cricothyroid)		*If unable to intubate, may need cricothyrotomy (though will not help if obstruction distal to cricothyroid)
	===Partial Obstruction===		===Partial Obstruction===
	*Supplemental O2		*Supplemental [[O2]]
	*Allow patient to assume position of comfort		*Allow patient to assume position of comfort
	*Monitor closely		*Monitor closely

2019-07-03T05:46:01Z

← Revisión anterior	Revisión del 05:46 3 jul 2019
(Sin diferencias)

2018-11-20T22:38:19Z

Differential Diagnosis

← Revisión anterior		Revisión del 22:38 20 nov 2018
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	==Differential Diagnosis==		==Differential Diagnosis==
	{{Stridor DDx}}		{{Stridor DDx}}
	~~===<6mo===~~
	*[[Laryngotracheomalacia]]		{{Pediatric stridor DDX}}
	*Vocal cord paralysis (weak cry)
	*[[Subglottic stenosis]] (previous intubation)
	*Airway hemangioma (usually regresses by age 5)
	*[[Vascular ring]]/sling

	==Evaluation==		==Evaluation==

2018-02-09T02:22:00Z

Evaluation

← Revisión anterior		Revisión del 02:22 9 feb 2018
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	**Negative in >50% of tracheal foreign bodies, 25% of bronchial foreign bodies<ref>		**Negative in >50% of tracheal foreign bodies, 25% of bronchial foreign bodies<ref>
	Zerella JT, Dimler M, McGill LC, Pippus KJ: Foreign body aspiration in children: value of radiography and complications of bronchoscopy. J Pediatr Surg 33: 1651, 1998.</ref>, and may be missed if very small and/or radiopaque		Zerella JT, Dimler M, McGill LC, Pippus KJ: Foreign body aspiration in children: value of radiography and complications of bronchoscopy. J Pediatr Surg 33: 1651, 1998.</ref>, and may be missed if very small and/or radiopaque
	**Inspiratory/expiratory films may show relative hyperinflation proximal to obstruction on end-expiration		**Inspiratory/expiratory films may show relative hyperinflation proximal to obstruction on end-expiration
			**Consider lateral decubitus films on right and left side

	==Management==		==Management==

2016-12-19T12:16:39Z

Text replacement - "Laryngoscopy" to "Laryngoscopy"

← Revisión anterior		Revisión del 12:16 19 dic 2016
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	*If conscious: Heimlich maneuver, chest thrusts (obese or pregnant patients), back-blow/chest thrust (infants)		*If conscious: Heimlich maneuver, chest thrusts (obese or pregnant patients), back-blow/chest thrust (infants)
	*If object visible, remove manually (don't push it further into airway!)		*If object visible, remove manually (don't push it further into airway!)
	*Laryngoscopy, remove visualized object with Magill forceps		*[[Laryngoscopy]], remove visualized object with Magill forceps
	*If unsuccessful, bag-valve mask or intubate (may dislodge object and improve situation to partial or more distal obstruction)		*If unsuccessful, bag-valve mask or intubate (may dislodge object and improve situation to partial or more distal obstruction)
	*If unable to intubate, may need cricothyrotomy (though will not help if obstruction distal to cricothyroid)		*If unable to intubate, may need cricothyrotomy (though will not help if obstruction distal to cricothyroid)