FOREIGN BODY IN RESPIRATORY TRACT

Foreign bodies aspiration is often seen during childhood.

They include TYPES: AGE- Younger than 3 years account for 73% cases.
Non-organic (buttons, metallic
1) Laryngeal Foreign Bodies
objects)
2) Tracheal Foreign Bodies
Foreign bodies may be found in Organic (eatables, peanuts, etc.)
3) Bronchial Foreign Bodies
(1) The Larynx (2) Trachea (3) Bronchi
material
& LARYNGEAL FOREIGN BODIES:TRACHEAL FOREIGN BODIES:BRONCHIAL FOREIGN BODIES:1) Croupy or hoarse cough
1) Cough
1) Cough, Wheeze, Blood-streaked sputum may occur
2) Aphonia
2) Hoarseness
2) With slight obstruction, passage of air in both
3) Haemoptysis
3) Dyspnoea
directions produces only wheezing
4) Dyspnoea
4) Cyanosis
3) With complete obstruction, atelectasis occurs due to
5) Wheezing
5) Wheeze with audible slab &
absorption of air distal to the obstruction
6) Cyanosis
palpable thud produced due to
4) History of choking, gagging, paroxysmal coughing,
momentary expiratory impaction
history of eating substances like groundnuts etc. is vital
at the subglottic level are
in the diagnosis
characteristic.
5) On examination tracheal shift, decreased breath sounds
on side of the FB aspiration occurs.
LARYNGEAL FOREIGN BODIES:TRACHEAL FOREIGN BODIES:BRONCHIAL FOREIGN BODIES:1) X-ray Neck- Lateral view
1) Chest X-ray
1) X-ray Chest
2) Laryngoscopy
2) Bronchoscopy
2) Fluoroscopy
Laryngeal FB needs to be removed by rigid endoscope.
Tracheotomy may be required with severe degree of dyspnoea.
Lobectomy may be required for longstanding vegetal FB.
Chest physiotherapy and bronchodilators should not be given (these may lead to disimpaction & movement of the FB with obstruction of a
more distal airway)
Antibiotics are needed for secondary infections.
BACK BLOWS:CHEST THRUSTS: Hold the infant face down on your forearm, which in turn should Now turn the infant around as a unit to a supine position while firmly
rest on your thigh.
supporting the head and neck. Administer up to five quick chest
Support the head of the child by firmly holding the jaw.
thrusts in the similar method and location used for chest compressions.
Position the infants head lower than the trunk.
The whole process is repeated until the foreign body is expelled out.
Deliver up to five blows with heel of your hand between the
shoulder blades of the infant.
HEIMLICH MANEUVER : (SUB-DIAPHRAGMATIC ABDOMINAL THRUSTS)
The maneuver is used in children older than 1 year. The aim is to increase the intrathoracic pressure and creating an artificial cough, so as to
force the foreign body out of the airway.
Heimlich maneuver is not used in infants for the risk of liver injuries.
It is carried out differently for conscious and unconscious children.
HEIMLICH MANEUVER : CONSCIOUS CHILD
HEIMLICH MANEUVER : UNCONSCIOUS CHILD
Stand behind the child and encircle his torso but putting both arms directly Position the child in a supine position and kneel at the
under his axillae.
childs feet.
Place the thumb side of one fist against the childs abdomen in midline slightly Place the heel of hand on the childs abdomen in the
above navel and well below the xiphoid.
midline slightly above navel and well below rib cage.
With other hand, grasp this fist and exert quick upward thrusts taking care not Place the second hand on top of the first and press into
to touch the xiphoid process or lower rib margins.
abdomen with quick upward thrust.
Each thrust should be forceful enough and intended to relieve the obstruction.
Prevention is of utmost importance with small objects being placed beyond the reach of young children.
Nuts, small toys with lose parts, coins should never be given to young children.

INTRODUCTION

SIGN
SYMPTOMS

DIAGNOSIS
TREATMENT

PREVENTION