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All of the following should undergo emergent foreign body retrieval EXCEPT:<br />
<br />
a) A 3 year-old who was witnessed to ingest a button battery 45 minutes ago<br />
<br />
b) A 10 year-old with cerebral palsy who has been coughing for the past 2 hours<br />
since lunchtime<br />
<br />
c) A 9 month-old who was found with peanuts in his hand and is wheezing<br />
<br />
d) A 2 year-old who swallowed a damaged tooth fragment and has a radiograph<br />
showing the tooth in the stomach<br />
<br />
e) A 3 year-old with a dime lodged in the upper esophagus with no symptoms.<br />
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==Answer==<br />
Answer d. Each of these patients requires retrieval of foreign body for various<br />
reasons. Patient A is at risk of life-threatening erosion due to the button battery.<br />
Patients B and C have active symptoms of a foreign body in the airway (patient C<br />
may also be having an allergic reaction, but it is prudent to rule out foreign body<br />
in this case). Patient E has no symptoms but a high-risk of conversion from<br />
esophageal to airway foreign body without intervention. Patient D has ingested a<br />
non-damaging foreign body and it has already passed the lower esophageal<br />
sphincter; this usually does not require further intervention.<br />
==Notes==<br />
<references /><br />
:This question originally printed in the [http://www.amazon.com/Justin-L.-Lockman/e/B00FLG5AEE/ref=ntt_dp_epwbk_0 Pediatric Anesthesiology Review Topics] kindle book series, and appears courtesy of Naerthwyn Press, LLC.<br />
==Keywords==<br />
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