Upper airway obstruction in an adolescent: Can airway foreign bodies be missed without self-reporting?
Publication date: Available online 21 February 2020Source: Respiratory Medicine Case ReportsAuthor(s): Hiroshi Fukumasa, Satoshi Tsuji, Kengo Kawamura, Nao NishimuraAbstractUpper airway obstruction due to foreign body aspiration is rare in adolescents. Diagnosis of the same is difficult, and incorrect, delay of treatment is common in patients with no aspiration history. Herein, we describe the case of a 15-year-old boy who presented with upper airway obstruction because of swallowing chewing gum 4 days before presentation. The patient was initially misdiagnosed and was scheduled for an emergency tracheotomy. However, this unnecessary surgical procedure was narrowly avoided because his symptoms resolved after he expelled the chewing gum from his airway. Despite being questioned several times about aspiration of any foreign bodies, he did not self-report the incident because he did not suspect that his symptoms were due to swallowing of the chewing gum.
Conclusions: SMART provided promising oncologic outcomes at the cost of significant treatment related morbidity. Due to the significant treatment associated morbidity and favorable treatment alternatives, we have not broadly adopted SMART at our institution.
In this study, changes in the position of the endotracheal tube tip during extension of the head and neck for a tracheotomy were investigated. Twelve patients underwent placement of a tracheotomy during surgical procedures for oral cancer. After nasal intubation, the distance between the tube tip and the carina was measuring using a fiberoptic scope with the patient's head placed at an angle of 110°. Patients were repositioned for tracheotomy by placing a pillow under the shoulders and extending the head and neck at an angle of 140°. The distance measurements were subsequently repeated. The difference between the f...
Conclusions: The findings from this meta-analysis suggest that early tracheostomy in severe traumatic brain injury patients contributes to a lower exposure to secondary insults and nosocomial adverse events, increasing the opportunity of patient’s early rehabilitation and discharge.
ConclusionAlthough limited by its small size and non-blinded design, this is the first study demonstrating the benefits of PES in ICU patients still orally intubated, thus offering a potential new method to reduce morbidity, mortality, and economic burden in a mixed ICU population. In order to further investigate and strengthen our findings, a statistically powered, randomized controlled study is recommended.
Abstract Smoke inhalation injury (SII) affects more than 50,000 people annually causing carbon monoxide (CO) poisoning. Although the increased blood level of carboxyhemoglobin (CO-Hb) is frequently used to confirm the diagnosis of SII, knowledge of its elimination in the acute phase is still limited. The aim of this study is to determine CO-Hb elimination rates and their differences in arterial (aCO-Hb) and mixed-venous (vCO-Hb) blood following severe SII in a clinically relevant ovine model. Forty-three chronically instrumented female sheep were subjected to SII (12 breaths, 4 sets) through tracheostomy tube unde...
CONCLUSIONS: The laryngeal mask as primary airway device is feasible and safe in patients undergoing laryngotracheal surgery even in cases with high-grade stenosis. PMID: 32199826 [PubMed - as supplied by publisher]
Abstract BACKGROUND: Ethnicity may be associated with important aspects of end-of-life care, such as what treatments are received, access to palliative care and where people die. However, most studies have focused on end-of-life care of white, Hispanic and black patients. We sought to compare end-of-life care delivered to people of Chinese and South Asian ethnicity with that delivered to others from the general population, in Ontario, Canada. METHODS: In this population-based cohort study, we included all people who died in Ontario, Canada, between Apr. 1, 2004, and Mar. 31, 2015. People were identified as ha...
Conditions: Tracheostomy Complication; Simulation of Physical Illness; Teach-Back Communication Intervention: Behavioral: Simulation Sponsors: Medical College of Wisconsin; Children's Hospital and Health System Foundation, Wisconsin Recruiting