All of the following should undergo emergent foreign body retrieval EXCEPT:
a) A 3 year-old who was witnessed to ingest a button battery 45 minutes ago
b) A 10 year-old with cerebral palsy who has been coughing for the past 2 hours
since lunchtime
c) A 9 month-old who was found with peanuts in his hand and is wheezing
d) A 2 year-old who swallowed a damaged tooth fragment and has a radiograph
showing the tooth in the stomach
e) A 3 year-old with a dime lodged in the upper esophagus with no symptoms.
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Answer
Answer d. Each of these patients requires retrieval of foreign body for various
reasons. Patient A is at risk of life-threatening erosion due to the button battery.
Patients B and C have active symptoms of a foreign body in the airway (patient C
may also be having an allergic reaction, but it is prudent to rule out foreign body
in this case). Patient E has no symptoms but a high-risk of conversion from
esophageal to airway foreign body without intervention. Patient D has ingested a
non-damaging foreign body and it has already passed the lower esophageal
sphincter; this usually does not require further intervention.
Notes
- This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.
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