Fractured intubating stylet: A case of airway foreign body in Intensive care Unit

A 62-year-old man was referred to the emergency department with retrosternal chest pain for 4 days. Coronary angiogram and ECG showed no occlusion of coronary vessels. Contrast-enhanced CT of thorax showed b/l pleural effusion, pneumomediastinum, right hydropneumothorax, with the underlying collapse of lungs and intercostal drainage tube in situ. Intercostal tube showed purulent discharge. Repeat oral contrast did not show any leakage through the upper gastrointestinal tract, and the patient is admitted to the intensive care unit following endotracheal intubation. However, an upper gastrointestinal endoscopy, performed at the bedside in the intensive care unit unexpectedly revealed a foreign body (piece of coconut shell) impacted at the lower oesophagus. The foreign body was removed successfully using oesophagoscopy, and the patient made a full recovery following multidisciplinary teamwork between critical care and surgeons.

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Frequency of foreign body inhalation in eight month duration admitted in Paediatric intensive care unit of Abbasi Shaheed hospital (tertiary care centre)

International Journal of Growth and Development ◽

10.25081/ijgd.2017.v1i1.32 ◽

2017 ◽

Vol 1 (1) ◽

pp. 31

Author(s):

Ashfar Alam Mallick

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Foreign Body ◽

Respiratory Distress ◽

Tertiary Care ◽

Case Series ◽

Betel Nut ◽

Rapid Improvement ◽

Tertiary Care Centre ◽

Foreign Body Inhalation

We present four cases of foreign body inhalation in eight month period (May-Dec 2016) admitted in pediatric intensive care unit (p.i.c.u) of Abassi Shaheed Hospital. Age range was eleven months to four years. Male gender was predominant among the case series. All of the cases presented with sudden onset of respiratory distress along with fever and cough. On examination all patients were febrile, tachpneic, tachycardic with subcostal and intercostal recessions. A working diagnosis of severe pneumonia was made and child was put on intravenous antibiotics and nebulizations. After 48 hours of admission, there was no improvement clinically so suspicion of foreign body was made on the basis chest of x-ray. Rigid bronchoscopy was done; foreign body peanut (1), chicken bone (1) and betel nut (2) were found. All children showed rapid improvement after removal of foreign body and were discharged soon after. Parents were counseled regarding addiction of betel nut and avoidance of foreign body inhalation in growing children. Hence we conclude that foreign body inhalation should be kept as a differential diagnosis in every child presenting with respiratory distress without improvement despite treatment. Parents should also be counseled for being vigilant around their children. There is no conflict of interest.

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ESOPHAGEAL FOREIGN BODY REMOVAL IN THE PEDIATRIC INTENSIVE CARE UNIT

Pediatric Critical Care Medicine ◽

10.1097/00130478-200509000-00066 ◽

2005 ◽

Vol 6 (5) ◽

pp. 628

Author(s):

S Abd-Allah ◽

M Rocha ◽

G Lam ◽

M Gross ◽

T Simeon ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Foreign Body ◽

Pediatric Intensive Care Unit ◽

Pediatric Intensive Care ◽

Esophageal Foreign Body ◽

Foreign Body Removal

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The Psychosocial Aspects of Feeding in the Neonatal Intensive Care Unit and Beyond

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_persp-19-00097 ◽

2019 ◽

Vol 4 (6) ◽

pp. 1507-1515

Author(s):

Lauren L. Madhoun ◽

Robert Dempster

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Hospital Discharge ◽

Neonatal Intensive Care ◽

Oral Feeding ◽

Medical Attention ◽

Primary Role ◽

Speech Language Pathologists ◽

The Family

Purpose Feeding challenges are common for infants in the neonatal intensive care unit (NICU). While sufficient oral feeding is typically a goal during NICU admission, this can be a long and complicated process for both the infant and the family. Many of the stressors related to feeding persist long after hospital discharge, which results in the parents taking the primary role of navigating the infant's course to ensure continued feeding success. This is in addition to dealing with the psychological impact of having a child requiring increased medical attention and the need to continue to fulfill the demands at home. In this clinical focus article, we examine 3 main areas that impact psychosocial stress among parents with infants in the NICU and following discharge: parenting, feeding, and supports. Implications for speech-language pathologists working with these infants and their families are discussed. A case example is also included to describe the treatment course of an infant and her parents in the NICU and after graduation to demonstrate these points further. Conclusion Speech-language pathologists working with infants in the NICU and following hospital discharge must realize the family context and psychosocial considerations that impact feeding progression. Understanding these factors may improve parental engagement to more effectively tailor treatment approaches to meet the needs of the child and family.

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