Foreign-body airway obstruction - PowerPoint Presentation

Slide1

Foreign-body airway obstruction

Dr

f.mohammadi

Emergency medicine specialist

Slide2

epidemiology

More common in

children

(1-3 years)

Male

to female: 2-1

Mean age in adult: 60 years

Slide3

cont

More common in adult with:

Oropharyngeal procedure

Various oral appliances

Intoxication

Sedation

Neurological or psychiatric disorder

Slide4

FBAO

Commonly

witnessed

Treatment usually

successful

Survival rate: 95%

50% removal before EMS arrival

85% of remain removed by EMSOnly 4% need to other intervention

Slide5

Location of object:

Depends on age and patient position

Large : larynx or trachea

Less large: beyond carina

Right bronchus :3 times more common

Slide6

Aspirated things:

Seeds

Nuts

Bone fragments

Nails

Small toys

Coin pins

Dental appliances…

Slide7

Scenario1:

A young man with his friends in restaurant was speaking and laughing.

After few minutes he begins to cough serially .

He coughs strongly and without stop.

Slide8

What should you do?

Perform Heimlich maneuver

Perform chest thrust

Give 5 back slaps

Just observe him

Slide9

Sign of severe obstruction:

Inability to speak or breath

Increased breathing difficulty

Silent cough

Cyanosis

Altered mental status

Slide10

Are you choking?

Slide11

Scenario2:

An old woman is eating her meal.

She becomes cyanotic and begins to cough.

But her coughs are weak.

Slide12

What should you do?

Beginning CPR

Perform abdominal thrust

Remove foreign body by finger

Just activating EMS

Slide13

Abdominal thrust

Slide14

Abdominal thrust

Repeat it until effective

or victim becomes unresponsive

Complications: stomach rupture, esophageal perforation, mesenteric laceration,..

Slide15

Scenario 3:

In last scenario, the caregiver calls EMS and starts to abdominal thrust

.

She repeats this maneuver ….

But after few minutes the patient becomes unresponsive.

Her breathing isn’t normal.

Slide16

What is the best intervention?

Checking pulse

Starting CPR

Just chest thrust

Finger sweep

Slide17

If victim becomes unresponsive:

send someone to Active EMS

Lower victim to floor

Unresponsive+ no breathing or no normal breathing : start CPR

WITHOUT CHECKING PULSE

Slide18

IF you are alone: continue CPR up to 5 cycles or 2 min

Then call EMS

Before each breathing: look mouth

Perform a finger sweep only if a solid object is seen( not blindly)

Slide19

Scenario4:

A 34 weeks pregnant woman is eating some nuts.

Suddenly starts to cough and becomes cyanotic.

Her husband is near her.

Slide20

What is the best intervention?

Abdominal thrust ( upper the uterus)

Chest thrust in upright position

Chest thrust in supine position

Back slaps

Slide21

Chest thrust

In obese and pregnant patients

Slide22

Scenario 5:

A 2 years old child is playing with her toys.

But suddenly starts to cough.

She cries but without sound!!!

Slide23

What is the best intervention?

Abdominal thrust

Chest thrust

5 back slaps-5 chest thrusts

Activation of EMS and observation

Slide24

FBAO in children( 1 years to puberty)

Are you chocking?

Abdominal thrust

Repeat until effective or becomes unresponsive

Slide25

Scenario6:

A 6 months infant is playing.

he eats a piece of her toys .

Starts to cough . he has stridor and becomes cyanotic.

Slide26

What is the best intervention?

Abdominal

thrust

Chest

thrust

5 back slaps-5 chest

thrusts

Activation of EMS and observation

Slide27

FBAO in infants( less than 1 year)

Confirm severe obstruction

5 back slaps- 5 chest thrusts

Both of them in head- down position

Repeat until effective or becomes unresponsive

Slide28

Slide29

Any question?

Slide30

Thanks for your attention