Foreign Body Aspiration History Choki g Gagging leering Hoarseness Dysphonia Can mimic asthma, croup pneumonia A positive history must never be ignored, while a negative history may be misleading
Foreign Body Aspiration ◼ History ◼ Choking ◼ Gagging ◼ Wheezing ◼ Hoarseness ◼ Dysphonia ◼ Can mimic asthma, croup, pneumonia ◼ “A positive history must never be ignored, while a negative history may be misleading
Foreign body aspiration Choking episode with coughing, gagging or wheezing Asymptomatic interval 20-50% not detected for one week Inflammation and Complications Cough Emphysema Obstructive atelectasis Hemoptysis Pneumonia Lung abscess Fever
Foreign Body Aspiration ◼ Choking episode with coughing, gagging or wheezing ◼ Asymptomatic interval ◼ 20-50% not detected for one week ◼ Inflammation and Complications ◼ Cough ◼ Emphysema ◼ Obstructive atelectasis ◼ Hemoptysis ◼ Pneumonia ◼ Lung abscess ◼ Fever
Foreign body aspiration a Physical exam Larynx/cervical trachea Inspiratory or biphasic stridor Intrathoracic trachea Prolonged expiratory wheeze bronchi Unequal breath sounds Diagnostic triad -<50% Unilateral wheeze Cough Ipsilaterally diminished breath sounds Fiberoptic laryngoscopy
Foreign Body Aspiration ◼ Physical exam ◼ Larynx/cervical trachea ◼ Inspiratory or biphasic stridor ◼ Intrathoracic trachea ◼ Prolonged expiratory wheeze ◼ Bronchi ◼ Unequal breath sounds ◼ Diagnostic triad - <50% ◼ Unilateral wheeze ◼ Cough ◼ Ipsilaterally diminished breath sounds ◼ Fiberoptic laryngoscopy
Foreign Body Aspiration a Radiography pa lateral views of chest neck Inspiration expiration Lateral decubitus views Airway fluoroscopy 25% have normal radiography
Foreign Body Aspiration ◼ Radiography ◼ PA & lateral views of chest & neck ◼ Inspiration & expiration ◼ Lateral decubitus views ◼ Airway fluoroscopy ◼ 25% have normal radiography