| MCV ENT UPDATE | |
| Update : January - March 2007 | |
| TRACHEAL FOREIGN BODY MANAGEMENT |
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When infants and small children aspirate objects they tend to lodge in the right main bronchus. Severe complications are encountered when such material lodges above the carina. Especially organic material like nuts and seeds cause problems as they tend to swell and cause intense reaction.
A 10 month old infant was brought with history of aspirating a large areca nut with severe respiratory distress. On that day 1 ½ year old Kavya was undergoing a cochlear implant and the second operation theatre was prepared immediately. The oxygen level was 50% and bradycardia was setting in. Dr.Kandaswamy, senior anaesthesist oxygenated, paralysed the infant and with a ventilating bronchoscope the blocking nut was pushed into the left bronchus. With this method the right lung was ventilated and the patient stabilized after which the nut was extracted.
Another 10 year old child in a similar incident had a tamarind seed which was also swollen up and it had become so big that it was not possible to pullout via the narrow subglottis. After several futile attempts a tracheostomy was made through which the nut was extracted and the baby was saved. |
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