Foreign body aspiration is most common in children under age 3. Common foreign bodies aspirated by children include nuts, seeds, and pieces of food. Most foreign bodies become lodged in the right main bronchus or left main bronchus. Presentation may include sudden coughing, wheezing, stridor, or recurrent pneumonia. Diagnosis is made through chest x-ray, fluoroscopy, or bronchoscopy. Emergent management involves back blows, chest compressions, or Heimlich maneuver to dislodge the object. Rigid bronchoscopy under anesthesia is the gold standard for removing impacted foreign bodies to prevent complications like bronchitis, abscess, or respiratory failure.
COMPLETE EXAMINATION OF RESPIRATORY SYSTEM IN PEDIATRICS. IT HAS BEEN SUMMARIZED FROM ALL WELL KNOWN 32 BOOKS UNDER GUIDANCE OF ONE OF THE BEST PEDIATRIC DOCTORS AND PROFESSORS .
BY DR. SURAJ R. DHANKIKAR.
how to examine sick baby , approach to child medical examination , diagnosis of sick child , evaluation of sick baby , medical examination of children , child medical history and examination , care of children
COMPLETE EXAMINATION OF RESPIRATORY SYSTEM IN PEDIATRICS. IT HAS BEEN SUMMARIZED FROM ALL WELL KNOWN 32 BOOKS UNDER GUIDANCE OF ONE OF THE BEST PEDIATRIC DOCTORS AND PROFESSORS .
BY DR. SURAJ R. DHANKIKAR.
COMPLETE EXAMINATION OF RESPIRATORY SYSTEM IN PEDIATRICS. IT HAS BEEN SUMMARIZED FROM ALL WELL KNOWN 32 BOOKS UNDER GUIDANCE OF ONE OF THE BEST PEDIATRIC DOCTORS AND PROFESSORS .
BY DR. SURAJ R. DHANKIKAR.
how to examine sick baby , approach to child medical examination , diagnosis of sick child , evaluation of sick baby , medical examination of children , child medical history and examination , care of children
COMPLETE EXAMINATION OF RESPIRATORY SYSTEM IN PEDIATRICS. IT HAS BEEN SUMMARIZED FROM ALL WELL KNOWN 32 BOOKS UNDER GUIDANCE OF ONE OF THE BEST PEDIATRIC DOCTORS AND PROFESSORS .
BY DR. SURAJ R. DHANKIKAR.
Approach to non-infectious Upper Airway Obstruction “Stridor” in children.pptxJwan AlSofi
This lecture will discus the approach to stridor / upper airway obstruction in children and paediatric age group.
Topics to be discussed:-
Upper Airway Obstruction (UAO):- eitiology, clinical features, invetigations, treatment
Foreign Body Aspiration
Choanal Stenosis (Atresia)
Laryngomalacia (Floppy Larynx)
Subglottic Stenosis
Adenoidal and Tonsillar Hypertrophy
Others causes of UAO
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Approach to non-infectious Upper Airway Obstruction “Stridor” in children.pptxJwan AlSofi
This lecture will discus the approach to stridor / upper airway obstruction in children and paediatric age group.
Topics to be discussed:-
Upper Airway Obstruction (UAO):- eitiology, clinical features, invetigations, treatment
Foreign Body Aspiration
Choanal Stenosis (Atresia)
Laryngomalacia (Floppy Larynx)
Subglottic Stenosis
Adenoidal and Tonsillar Hypertrophy
Others causes of UAO
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
1. FOREIGN BODY ASPIRATION
IN CHILDREN
PREPARED BY:
NOOR HADI
WASIT UNIVERSITY COLLEGE OF MEDICINE
IRAQ
20-4-2017
2. Epidemiology
Ages affected
Age <3 years old: 50%
Age <10 years old: 95%
incidence
Age : 6months -3years
Sex : male > female
3. Etiology
children comprise the most common age group for foreign body aspiration because of the
following:
They tend to put objects in their mouth more frequently.
They lack molars for proper grinding of food.
They tend to be running or playing at the time of aspiration.
They lack coordination of swallowing and glottis closure.
Children often examine even nonfood substances with their mouth.
Even immobile infants may aspirate foreign bodies, despite not having the ability to crawl and
find things or the ability to pick up objects and put them in the mouth.
5. Location of Impacted Foreign Bodies
Larynx 1-5%
Trachea 5-15%
L Main Bronchus 30-35%
R Main Bronchus 30-40%
L Lobar Bronchus 5-15%
R Lobar Bronchus 5-15%
6. presentation
Often, the child presents after a sudden episode of coughing or choking while eating with
subsequent wheezing, or stridor.
Laryngeal Foreign Body; Hoarseness ,Croupy cough ,Aphonia ,Hemoptysis ,Dyspnea
with wheezing and Cyanosis
Tracheal Foreign Body; Asthmatic wheeze
Bronchial Foreign Body; Initially: cough, blood-streaked sputum.
Asymptomatic , signs of asphyxia and wheezing
A fever may be present. If the child has been febrile, it is important to consider the
possibility that the object may be contaminated or chemically irritating.
The most tragic cases occur when acute aspiration causes total or near-total occlusion of the
airway, resulting in death or hypoxic brain damage.
The more difficult cases are those in which aspiration is not witnessed or is unrecognized and,
therefore, is unsuspected.
The child may present with persistent or recurrent cough, wheezing, persistent or
recurrent pneumonia, lung abscess, focal bronchiectasis, or hemoptysis.
7. Physical examination:
Decrease breath sound distally to F. B .
Unilateral wheezing
Tachypnea
Inability to speak
Limited chest expansion
Impaired percussion note
Signs of resp. distress
Sounds are inspiratory if the material is in the extra thoracic trachea. If the lesion is in the
intra thoracic trachea, noises are symmetric but sound more prominent in the central airways.
These sounds are a coarse wheeze (sometimes referred to as expiratory stridor) heard with the
same intensity all over the chest.
Once the foreign body passes the carina, the breath sounds are usually asymmetric.
In bronchial foreign body there is limited expansion, decreased vocal fremitus, impaired or
hyper resonant percussion and diminished breath sounds.
Similarly, a lack of findings upon physical examination does not preclude the possibility of an
airway foreign body
9. Investigations
(a) Plain Chest X-ray(CXR): 80% of laryngotracheal
FB and 15-28% of bronchial FB can have normal
CXR.
Nonetheless, plain X-rays in inspiration and
expiration are useful.
10.
11. (b) Fluoroscopy: Fluoroscopy being a dynamic method of evaluation is more
sensitive than plain X-ray.
It is most useful when radiolucent FB is suspected and plain X-ray is
inconclusive.
In the above situations, fluoroscopy would show phasic mediastinal shift.
Mediastinal shift during inspiration indicates the side of FB.
In suspected chronic FB aspiration, investigations like CT
scan, and contrast study may be required.
12. Management
(a) Infants : 4 back blows with head held low followed by 4 chest compressions.
Visualize the pharynx with jaw lift, if FB is seen, extract (avoid blind finger
sweeps).
If above measures fail, give rescue breathing, then repeat the above procedure.
(b) Children above 1 year (Heimlich manoeuvre): 6-10 abdominal
thrusts, visualize pharynx, if FB is seen, extract.
If failed, give rescue breathing, then repeat the above procedure.
However, these measures should not be instituted in a child who is able
to speak or cry or is breathing.
13.
14.
15. If above measures fail:
urgent cricothyrotomy
tracheostomy.
Endotracheal intubation with smaller size tube.
16. Bronchoscopy
Once stabilized the child is kept nil orally.
Oxygen should be administered in cases with respiratory distress.
Dehydration and acid-base disturbances should be corrected before bronchoscopy.
Team efforts ; ENT senior surgeon and anaesthesiologist
Rigid bronchoscopes are the best.
No medications are needed. If significant swelling is observed in the airway or if granulation
tissue is present, a corticosteroid (eg, prednisolone, prednisone) may be administered. Unless
airway secretions are infected, antibiotics are not helpful or necessary.
Chronic bronchial FB may require:
thoracotomy or lobectomy.
17. Complications Of Retained
Foreign Bodies
Hemoptysis
Bronchiectasis
Bronchial stenosis
Pneumomediastinum/pneumothorax
Persistent/recurrent pneumonias
Acute/recurrent respiratory distress or failure
Death