Research about foreign bodies that is unintentionally aspirated (pediatrics)

1. by:Mohamed TarekTaha
Mahmoud Tarek Taha
group :11
Kabardino-Balkarian State University
Faculty of Medicine
Department of Peditarics R.A. Zhetishev, D.R. Arkhestova

2. INTRODUCTION
• Foreign body aspiration
refers to an object that is
unintentionally breathed
into the lungs, getting
lodged in one of the airways.
• This could be anything from
small toys, coins, pieces of
food

3. ANATOMY
• respiratory system consist of upper
and lower tract:
1-upper respiratory tract :
{Nose - Nasal cavity -Sinuses}
2-lower respiratory tract :
{larynx - trachea - Lungs - bronchi and
bronchioles - alveoli}

4. EPIDEMIOLOGY
in males more than females
developmentally delayed
individuals
food objects are most
commonly aspirated, with
peanuts ,hotdogs and hard
candy

5. ETIOLOGY
Nuts (e.g. peanuts, almonds) - most common cause
Hard candy or chunks of food
Tiny toy parts
Coins or buttons
foreign bodies mostly stop in upper respiratory tract and
sometimes to lower if the aspirated body is small

6. CLINICAL MANIFESTATION
1-upper airway is more severe
#can be classifaied to partial and complete
PARTIAL AIRWAY OBSTRUCTION
I. COUGH
II. GAG
III.CHOKE
IV. DROOL
V. DYSPNEA
VI. HOARSE when SPEAKING
VII.INSPIRATORY STRIDOR

7. cont.
• COMPLETE OBSTRUCTION
1-UNABLE to: COUGH - SPEAK - BREATHE
2-CYANOTIC
3-UNRESPONSIVE
2-Lower respiratory
• 1/2 CHILDREN ASYMPTOMATIC
• INITIALLY, may COUGH & GAG then SYMPTOMS GO AWAY
complications if untreated
ASPIRATION PNEUMONIA - EDEMA - ABSCESS

8. DIAGNOSIS
1-HISTORY
1-clinical signs
2-
"WHAT were they EATING or PLAYING with at the TIME?"
"WHAT ITEMS might have BEEN NEARBY?"
2-physical examination
Vital signs: Check temperature, heart rate, respiratory rate
and oxygen saturation. Signs of respiratory distress
1-Inspection: Note use of accessory muscles, chest movements, tracheal
tug/retraction.
2-Palpation: Feel for tracheal deviation, tenderness, crepitus

9. cont.
3-Percussion: Dullness over affected area indicates
consolidation.
4-Auscultation:
Decreased breath sounds over involved lung segment/lobe
Unilateral wheeze, crackles, stridor
• #if compleate airway obstruction emergancy oxygenation
should be deliverd

10. x
• emergancy 2 thumb

11. cont.
• 3-Imaging
• X-RAY :can only visualize radiopaque items (food is not
visible) +overinflation and lung infiltrate
• if X-RAY false negative :fluoroscopy and CT scan
• Laryngoscopy or bronchoscopy

12. cont.

13. TREATMENT
DEPENDS on CAUSE & LOCATION
MAINTAINING ADEQUATE VENTILATION
OXYGEN ADMINISTERED if NEEDED
SEVERE or COMPLETE OBSTRUCTION
HEIMLICH MANEUVER:
CHILDREN more than 1 year: 5x ABDOMINAL THRUSTS
REPEATEDLY.
Stand behind the child with fists clasped between the navel and below
the bottom of the breastbone. Give quick thrusts inward and upward.
CHILDREN <1year : 5 BACK BLOWS followed by 5 CHEST THRUSTS

14. HEIMLICH MANEUVER

15. cont.
LARYNGOSCOPY
if FAIL to REMOVE OBJECT
REMOVED by FORCEPS or SUCTION
if CHILD becomes UNRESPONSIVE
CARDIOPULMONARY RESUSCITATION (CPR)
if OBJECT LODGED in NASAL CAVITY PLUG
UNOBSTRUCTED NOSTRIL AND BLOW NOSE
AFTER REMOVAL :many CHILDREN GO HOME AFTER a
FEW hours of OBSERVATION , some STAY for
TREATMENT of more SERIOUS COMPLICATIONS such

16. PREVENTION
ONLY FEED when
SITTING UP
SMALL OBJECTS KEPT
OUT of their REACH
Children shouldn't run or
play while eating

17. transportation
Use caution when transporting to avoid dislodging or
further advancing the foreign body.
Explain situation calmly to child to avoid excessive
movement.
Consider ambulance transportation if airway
obstruction/distress is present.
If using private vehicle, keep child in parent's arms in rear-
facing child safety seat. Keep scene calm without loud
noise/movement.

18. transportation
Bring any knowledge of potentially aspirated item in case
urgently needed for x-ray visibility. Inform staff upon
arrival.
Monitor breathing closely - signs like increased work of
breathing, cough, wheeze, cyanosis warrant pulling over for
reassessment
Travel directly to nearest emergency department with
pediatric capabilities for airway evaluation and potential
bronchoscopy.

19. transportation
Notify staff upon arrival so team can promptly assess
airway/breathing and prepare for any interventions needed.

20. refrences
Research gate
osmosis
NIH national
library of medicine
who.int
mayoClinic