Good Afternoon

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Dr. DHANRAJ

Introduction

FOREIGN BODY ASPIRATION

Management of Foreign body aspiration in children

Foreign body aspiration

Aspiration of foreign bodies is a common problem occuring in children 90% deaths in the age group less than 5 years and out of these 40% were infants

Terms
Foreign bodies

Aspiration

is the entry of material (from the oropharynx or gastrointestinal tract into the larynx (voice box) and lower respiratory tract (the portions of the respiratory system from the trachea (windpipe) to the lungs)

Ingestion

is the passage of a substance from the mouth into the gastrointestinal tract

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In children
Epiglottis doesnt close as in adults Narrow airways Increases the risk of aspiration in children

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Signs and symptoms

Three phases depending upon the size, shape and where it finally lands up:
1) Acute signs and symptoms owing to the cough or gag reflexes 2) Quiet phase 3) Later phase

Universal sign is CHOKING SIGN

How will you recognize..

Signs of partial airway Signs ofobstruction airway complete

obstruction With good air flow Forceful cough Inability to speak Wheezing between Inability to breathe cough Ability to breathe Inability to cough
Universal choking sign With poor air exchange
Panic Weak,ineffectual cough
Crowing sound on inspiration Paradoxical respiration Absent or altered voice sounds Possible cyanosis Possible disorientation

Foreign objects encountered

Stainless steel crowns
Text

Endodontic instruments

odontic bands

Foreign bodies
Rubber dam clamps

Prosthe sis

What will you do if such emergency situation occurs..

Management
Management

Invasive

Non-Invasive

The ultimate aim is to establish a emergency airway

Non invasive procedures

Back blows Heimlich maneuver

Chest thrust
Finger sweep

In infants
In a choking CONSCIOUS INFANT 1. Position with head downward 2. 5 back blows 3. 5 chest thrusts 4. Repeat In an UNCONSCIOUS INFANT 1. Assess 2. Begin CPR if needed 3. Check for object prior to each breath

In children
Children aged 1 to 8 years

Give 5 abdominal thrusts (Heimlich maneuver)

In an unconscious child..
Try to support victim with your knees while lowering victim to the floor Assess Begin CPR After chest compressions, check for object before giving breaths

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Diagnostic Investigations
If a foreign body is not retrieved and the patient is asymptomatic,

Complications.
Bronchial stenosis

Bronchiectasis
Lung abscess Tissue erosion/perforation

Our primary objective..

To prevent such incidents in a dental practice setup..

Ligature
Dental floss should be secured to..

Conclusion .
In a pediatric practice, proper caution and care should be exercised Its a must that each pediatric dentist should be aware of emergency management A proper protocol of instrument usage should be practised..