scholarly journals A Near Brush with Death: A Case Report on Oral Foreign Body Impalement

2019 ◽  
Vol 2 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Rachel Christner ◽  
Marisa Homer ◽  
Oliver Atar ◽  
Brian Hynes
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Foreign Body ◽  
Emergency Room ◽  
Operating Room ◽  
Pediatric Patient ◽  
Pediatric Patients ◽  
Conscious Sedation ◽  
Upper Airway

We describe a case of an 11-month-old baby presenting to the emergency room with a foreign body in the upper airway. After unsuccessfully attempting to remove the foreign body in the emergency department, the otolaryngologist was consulted. The patient was taken to the operating room, and a comb was successfully removed under conscious sedation. This case illustrates the need of a well-considered strategy for managing the airway of a pediatric patient with a foreign body, while also demonstrating the unique challenges of treating pediatric patients.

scholarly journals One Notable Complication of Nasopharyngeal Airway: A Case Report

2020 ◽  
Vol 4 (4) ◽  
pp. 584-586
Author(s):  
Blake Briggs ◽  
Chase Countryman ◽  
Henderson McGinnis
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Foreign Body ◽  
Airway Obstruction ◽  
Nasal Cavity ◽  
Critically Ill Patients ◽  
Upper Airway ◽  
Unique Case ◽  
Body Retention ◽  
Nasopharyngeal Airway

Introduction: The nasopharyngeal airway (NPA) is used by emergency providers and first responders to assist with oxygenation in obtunded, critically ill patients. There are few recorded NPA complications. Case Report: We describe a unique case in which a patient went multiple days with recurrent symptoms of upper airway obstruction secondary to retained NPA. Discussion: Nasopharyngeal airways may be uniquely prone to being displaced and retained due to their use in emergent situations, their small size, and time of insertion in the field prior to emergency department (ED) contact where handoff is not often standardized. Conclusion: The use of large-flanged NPAs might reduce incidences of displacement into the nasal cavity. This case highlights the need for improved handoff communication between emergency medical services and ED staff, especially to account for all inserted devices to prevent foreign body retention.

scholarly journals Bilateral Destructive Hip Disease from Untreated Juvenile Idiopathic Arthritis

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Arash Calafi ◽  
Alton W. Skaggs ◽  
Trevor J. Shelton ◽  
Brian M. Haus
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Case Report ◽  
Femoral Head ◽  
Pediatric Patient ◽  
Acetabular Dysplasia ◽  
Pediatric Patients ◽  
Similar Case ◽  
Hip Pain ◽  
Complete Destruction ◽  
Hip Disease

We report a novel case of a pediatric patient with bilateral hip destruction from untreated Juvenile idiopathic arthritis (JIA). She was presented at the age of 9 with hip pain associated with bilateral acetabular dysplasia and a dislocated left femoral head. Only 1.5 years later, the patient developed complete destruction of the left femoral head and dislocated right femoral head. The authors have not identified literature describing a similar case report of bilateral femoral head destruction resulting from Persistent Oligoarticular JIA. Pediatric patients presenting with rapidly evolving destructive process should be evaluated for rheumatologic, infectious, and spinal etiologies.

scholarly journals Life–threatening Pulmonary Oedema Secondary to Tracheal Compression

2002 ◽  
Vol 30 (6) ◽  
pp. 804-806 ◽  
Author(s):  
H. Butterell ◽  
R. H. Riley
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Airway Obstruction ◽  
Pulmonary Oedema ◽  
Negative Pressure ◽  
Upper Airway ◽  
Tracheal Compression ◽  
Negative Pressure Pulmonary Oedema ◽  
Life Threatening ◽  
Thyroid Goitre

We present a case of negative pressure pulmonary oedema due to an overlooked cause. A 45-year-old female patient presented to the emergency department unconscious with severe pulmonary oedema. Subsequent investigations revealed a thyroid goitre causing significant tracheal compression. This case report highlights an extremely rare but potentially dangerous sequela of upper airway obstruction.

scholarly journals Foreign body aspiration in an 11-month-old child; the importance of anamnesis and respiratory examination

2020 ◽  
Vol 10 (6) ◽  
pp. 156-157
Author(s):  
Muhammet Mesut Nezir ENGİN ◽  
Fatih ERDOĞAN ◽  
Özlem KÜÇÜK ◽  
Murat KAYA
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Foreign Body ◽  
Respiratory Distress ◽  
Mortality Rates ◽  
Pediatric Emergency ◽  
Foreign Body Aspiration ◽  
Morbidity And Mortality ◽  
Pediatric Emergency Department ◽  
Delay In Diagnosis

Foreign body aspiration (FBA) is common in children. Especially in children, the majority of accidental deaths occur due to FBA. Morbidity and mortality rates increase, especially in children between the ages of one and four, and as a result of delay in diagnosis. The most common symptoms in patients with FBA are cough, dyspnea, hemoptysis, stridor and wheezing. In this case report, a patient who presented with sudden respiratory distress in the Pediatric Emergency Department was presented and the importance of anamnesis and respiratory examination in the diagnosis of FBA was emphasized.

scholarly journals A prickly situation: an attempted Caterpillar ingestion - case report

2020 ◽  
Vol 49 (1) ◽  
Author(s):  
Amar K. Bhardwaj ◽  
Naif Fnais ◽  
Christopher J. Chin
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Foreign Body ◽  
Oral Cavity ◽  
Direct Laryngoscopy ◽  
Effective Technique ◽  
Efficient Manner ◽  
Case Presentation ◽  
Tussock Moth ◽  
Initial Method

Abstract Background Foreign body ingestion is a common problem in pediatrics. Each foreign body can present its’ own unique challenges during removal, and we present the management of an ingested Spotted Tussock Moth (Lophocampa maculata), more commonly known as a caterpillar. Case presentation An 18-month-old boy presented to the emergency department with difficulty handling secretions and odynophagia. It was reported he had placed a caterpillar in his mouth and then spat it out. On examination, hundreds of miniscule filaments (setae) were seen embedded in his lips and tongue. Our service was consulted out of concern for airway involvement. The patient was taken to the operating room where a direct laryngoscopy under general anesthesia with spontaneous ventilation was performed to confirm the setae were confined to the anterior tongue and lips. Once we were satisfied the airway was stable, the airway was secured, and we then began to remove the setae. The initial method used was to use Adson-Brown forceps to remove the setae, however this proved difficult and time-consuming given the volume of setae and how thin the setae were. Ultimately, a more effective technique was developed: a 4 × 4 AMD-RITMES® gauze was applied to the mucosa in order to dry up any secretions and then a piece of pink, waterproof BSN medical® tape was applied to the mucosa. After 3 s of contact it was removed. This technique was then repeated and was used to remove the vast majority of the setae. Conclusion To our knowledge, we have described the first technique to remove the caterpillar setae from the oral cavity mucosa in a fast, safe and efficient manner.

Conscious Sedation for Pediatric Peritonsillar Abscess: Comparison of Anesthetic Approaches

2019 ◽  
Vol 160 (4) ◽  
pp. 706-711 ◽  
Author(s):  
M. Elise Graham ◽  
Abigail K. Neal ◽  
Ian C. Newberry ◽  
Matthew A. Firpo ◽  
Albert H. Park
Keyword(s):  
Emergency Department ◽  
Chart Review ◽  
Pediatric Patients ◽  
Conscious Sedation ◽  
Case Series ◽  
Dental Trauma ◽  
Primary Outcome Measure ◽  
Peritonsillar Abscess ◽  
Incision And Drainage ◽  
Viable Treatment

Objective To compare the efficacy, safety, and cost of incision and drainage (I&D) for pediatric patients with peritonsillar abscesses (PTAs) under conscious sedation (CS) versus unsedated (awake) and general anesthesia (GA). Study Design Case series with chart review. Setting Tertiary pediatric hospital. Subjects and Methods Records for all pediatric patients (<18 years) treated for PTAs in the emergency department from 2005 to 2015 were reviewed and stratified into awake, CS, and GA groups for comparison. The primary outcome measure was procedure tolerance, with secondary measures including return to the emergency department within 15 days, complications, and facility costs associated with treatment. Results A total of 188 patients were identified. The median age was 14 years (interquartile range, 9-16). Awake drainage with injected local anesthetic was used in 115 children; 62 underwent CS; and 11 underwent GA. Over 92% of the children tolerated I&D regardless of anesthesia, with no difference among groups ( P = .60). None of those who underwent I&D via CS returned to the emergency department within 15 days of the procedure, as compared with 5.2% for the awake group and 9.1% for the GA group ( P = .06). None in the GA or awake group had a complication associated with the procedure, as opposed to 9.6% in the CS group ( P = .02). Complications included apnea and dental trauma (2 children each) and transient hypotension and desaturation (1 each). Cost was highest in the GA group and lowest for the awake group ( P < .0001). Conclusion CS for PTA I&D is a viable treatment option with tolerance and success similar to that of the awake and GA groups. Complications were observed for those who underwent CS, but they were manageable.

scholarly journals Recurrent Pituicytoma in a Pediatric Patient: A Case Report

2018 ◽  
Vol 37 (02) ◽  
pp. 119-122
Author(s):  
Miguel Maldonado-Morán ◽  
Jeisson Ospina ◽  
Juan Vega ◽  
Claudia Restrepo ◽  
Daniela Rico ◽  
...  
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Pediatric Patient ◽  
Glial Cells ◽  
Clinical Presentation ◽  
Present Report ◽  
Rare Tumor ◽  
Radiological Features ◽  
Long Time ◽  
Visual Disturbances

AbstractPituicytoma is a rare tumor that arises from the glial cells of the neurohypophysis. For a long time, it was believed that pituicytomas only appeared in adults. Currently, at least three cases of this entity occurring in children have been reported in the literature. The aim of the present report is to describe the case of a 5-year-old girl who presented to the emergency department with visual disturbances, and the diagnosis was a recurrent pituicytoma. Therefore, the clinical presentation, the radiological features of the tumor, and the corresponding surgical management are described. Additionally, a brief review of the management of this unusual entity was performed.

scholarly journals Ultrasound-guided removal of hypopharyngeal foreign body in the emergency department

Ultrasound ◽  
2017 ◽  
Vol 25 (4) ◽  
pp. 245-247
Author(s):  
Nadia Maria Shaukat ◽  
Alexis Lenz ◽  
Poonam Desai
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Operating Room ◽  
Ultrasound Guided ◽  
Partial Denture ◽  
Life Threatening ◽  
Foreign Body Impaction

Foreign body impaction at the cricopharyngeal level can be a life-threatening emergency. While traditionally, removal of these is performed in the operating room setting, patients with relatively unstable airways or significant discomfort may require immediate extraction to prevent further injury. This is the case of an 85-year-old man who presented to the emergency department in significant discomfort following aspiration of a large partial denture. We report here the first known use of ultrasound in an emergent airway situation to rapidly localize and retrieve an aspirated foreign body.

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