FOREIGN BODY OBSTRUCTION

1. MRS. ARUNA MANO
MSC (N),MEDICAL SURGICAL NURSING
LECTURER
GANGA COLLEGE OF NURSING
COIMBATORE

2. FOREIGN BODY
OBSTRUCTION

3. foreign-body airway
obstruction (FBAO) is the
fourth leading cause of unintentional death,
resulting in 5,051 documented deaths in 2015.
In children under the age of 16, foreign-body
airway obstruction is one of the leading causes
of accidental deaths.

4. Due to the prevalence and rapidity of unconsciousness and death
associated with choking, all persons, including those outside of the
health field, should have a basic understanding of how to care for a
choking victim.
Simple maneuvers taught to laypeople such as the Heimlich
maneuver have been proven to save lives. Besides complete foreign
body airway obstruction that is immediately life-threatening, partial
airway obstructions can impede gas exchange and lead to dyspnea,
pneumonia, and abscess formation.
CONTD…

5. DEFINITION:
A partial or complete blockage of
the breathing tubes to the lungs due to
a foreign body (for example, food, a
bead, toy, etc.). The onset of
respiratory distress may be sudden
with cough. There is often agitation in
the early stage of airway obstruction.

6. EPIDEMIOLOGY
 The incidence of nonfatal choking episodes is difficult to measure
because many of these events are transient and do not result in visits
to a hospital. Of the children who receive treatment for nonfatal
choking, food is the most common recipient, with 59.5% of cases
followed by nonfood items, such as coins, marbles, balloons, and
paper, with 31.4%. In 9.1% of cases, the cause was unknown.
 Among children, choking rates were highest among infants less than
one year, and over 75% of choking incidents occurred in children
under 3. No significant difference appeared in the choking rates
between boys and girls

7. CONT ..
Among adults, conditions associated with a higher risk of
choking include Alzheimer disease, parkinsonism, prior stroke,
intellectual or developmental disability, poor dentition, intoxication,
dysphagia along with psychotropic medications, and advanced age.
Researchers observed no significant difference in choking rates
between men and women. The estimated rates of fatal choking for
adults aged 18 to 64 are at 0.1 per 100000 and 0.7 per 100000 for
those over 65 years of age.

8. CAUSES
 Choking usually occurs while the person is eating or drinking
and can be associated with muscle, neurological or cerebral
Altered level
 Drug and/or alcohol intoxication
 Neurological impairment, with reduced swallowing and
cough reflexes (for example, stroke)

9. CONTD…
 Respiratory disease
 Mental impairment
 Dementia
 Poor dentition
 Older age

10. ETIOLOGICAL FACTORS
Smaller airways Decreased respiratory
reserves
Diphtheria

11. ETIOLOGICAL FACTORS
Factors that contribute to rapid
respiratory compromise in children include:
●increased metabolic demands
COMMON FACTORS INCLUDE:
●Swallowed or inhaled foreign objects

12. CONT ..
 Laryngitis
 Epiglottitis
 Peritonsillor abscess
 Anaphylaxis
 Chemical burns

14. PATHO-PHYSIOLOGY

15. SIGNS & SYMPTOMS
Usually the symptoms of a swallowed foreign objects are hard to miss
The most common symptoms include:
 Choking
 Difficulty breathing
 coughing
 Wheezing
 Dysphagia

21. COMMON CLINICAL MANIFESTATIONS
●Barking cough
●Respiratory distress
●Tachypnea
●Inspiratory stridor
●Hoarseness
●Elevated temperature
●Rapid pulse
●Irritability

26. MANAGEMENT:

27. FBAO ALGORITHM

28. FIRST AID MANAGEMENT

29. CONT..
 Mild airway obstruction (effective cough)
 Coughing generates high and sustained airway pressures and
may expel a foreign body, so it is important to encourage the
patient to cough.
 Aggressive treatment with back blows and chest and
abdominal thrusts at this stage is unnecessary – it may cause
harm and could exacerbate the airway obstruction.

30. CONT..
Severe airway obstruction (ineffective cough)
If the patient shows signs of severe airway obstruction:
Call for help/pull the emergency buzzer immediately and
encourage the patient to cough;
Stand at the patient’s side, slightly behind them;
Support the patient’s chest with one hand and lean them forward
– if this dislodges the foreign body, it will hopefully fall out of
the mouth instead of slipping further down the airway;
If symptoms continue, deliver up to five back blows (slaps)
between the scapulae using the heel of the hand Following each
back blow, check to see if the obstruction has been dislodged.

31. CONTD…
 If the back blows fail, proceed to abdominal thrusts
 Stand behind the patient, placing both arms around the upper abdomen;
 Lean the patient forward;
 Place a clenched fist between the patient’s umbilicus and the ribcage, and clasp it
with the other hand;
 Deliver up to five sharp thrusts to the abdomen, inwards and upwards;
 Take care not to apply pressure to the xiphoid process or the lower ribcage as this
may cause abdominal trauma;
 If the obstruction remains, alternate up to five back blows with up to five
abdominal thrusts.

32. Cont..

33. Cont..

34. CONT..
 Abdominal thrusts in an obese or pregnant patient:
 It may be difficult to carry out abdominal thrusts on a patient who is
obese or pregnant. If you cannot encircle their abdomen, stand
behind the patient, position your hands over the lower end of the
sternum and pull hard into the chest with quick thrusts (chest
thrusts)

35. CONT..
 Use of airway clearance devices:
Although there are several airway clearing devices for the treatment
of FBAO currently available, their routine use is not recommended by
the Resuscitation Council. However, appropriately trained health
professionals can use advanced techniques – such as suction or
laryngoscopy and forceps – to remove a foreign body from the airway.