Obstrução de vias aéreas por corpo estranho em crianças: atuação do enfermeiro

A Aspiração de corpo estranho (ACE) é definida como o ato de aspirar ou inalar um corpo estranho para dentro do trato respiratório. Isso ocorre principalmente na fase pediátrica, onde as crianças põem objetos na boca, podendo ocorrer uma obstrução completa. Enfatizar a importância da atuação do enfermeiro diante da emergência de aspiração por corpo estranho em crianças. Trata-se de uma revisão da literatura, através de artigos publicados nos últimos 6 anos, no período de 2014 a 2020. Como critérios de inclusão, foram utilizados artigos publicados em língua portuguesa, disponíveis nas bases de dados Scientific Eletronic Library Online (Scielo), Sociedade Brasileira de Pediatria (SBP) e sites governamentais. Após a leitura e análise dos artigos selecionados, surgiram 4 abordagens principais: Aspiração por corpo estranho na fase pediátrica; Manobra de Heimlich; O conhecimento dos pais em relação as manobras e Estratégias de enfermagem que favorecem a educação em saúde. O enfermeiro embasado de instrumento técnico-científico tem total autonomia e capacitação para identificar precocemente o grau de obstrução e realizar a manobra de Heimlich.Descritores: Aspiração, Acidente, Assistência, Enfermagem, Crianças. Obstruction of aerea ways by strange body in children: nurse's performanceAbstract: Foreign body aspiration (ACE) is defined as the act of aspirating or inhaling a foreign body into the respiratory tract. This occurs mainly in the pediatric phase, where children put objects in their mouth, with the possibility of complete obstruction. Emphasize the importance of the nurse's performance in face of the emergency of aspiration by foreign body in children. Review of the literature, through articles published in the last 6 years, from 2014 to 2020. As inclusion criteria, articles published in Portuguese were used, available in the Scientific Electronic Electronic Online (Scielo), Society databases of Pediatrics (SBP) and government websites. After reading and analyzing the selected articles, 4 main approaches emerged: Foreign body aspiration in the pediatric phase; Heimlich's maneuver; The parents' knowledge regarding the nursing maneuvers and strategies that favor health education. The nurse based on a technical-scientific instrument has full autonomy and training to identify the degree of obstruction early and perform the Heimlich maneuver.Descriptors: Aspiration, Accident, Assistance, Nursing, Children. Análisis de la ergonomía cognitiva en la enfermería en clínica de hemodiálisisResumen: La aspiración de cuerpo extraño (FCA) se define como el acto de aspirar o inhalar un cuerpo extraño en el tracto respiratorio. Esto ocurre principalmente en la fase pediátrica, donde los niños se llevan objetos a la boca y puede ocurrir una obstrucción completa. Enfatice la importancia del papel de la enfermera en la aparición de la aspiración de cuerpos extraños en los niños. Se trata de una revisión de la literatura, a través de artículos publicados en los últimos 6 años, de 2014 a 2020. Como criterios de inclusión se utilizaron artículos publicados en portugués, disponibles en las bases de datos de la Scientific Electronic Library Online (Scielo), Sociedad Brasileña of Pediatrics (SBP) y sitios web gubernamentales. Después de leer y analizar los artículos seleccionados, surgieron 4 abordajes principales: Aspiración de cuerpos extraños en la fase pediátrica; Maniobra de Heimlich; Conocimiento de los padres sobre las maniobras y estrategias de enfermería que favorecen la educación para la salud. Los enfermeros basados en un instrumento técnico-científico tienen total autonomía y formación para identificar precozmente el grado de obstrucción y realizar la maniobra de Heimlich.Descriptores: Aspiración, Accidente, Asistencia, Enfermería Niños.

Differential diagnosis of bovine intestinal diseases and their sequelae regarding ultrasonography and other diagnostic tools

Background and Aim: Intestinal disorders represented a large proportion of abdominal emergencies in bovine practice, and their definite diagnosis was a big challenge. The study described different intestinal disorders in cattle either in the small intestine (SI) or large intestine with their sequelae and peritonitis between SI loops. Materials and Methods: This study involved healthy (n=20) and diseased (n=40) cattle with intestinal disorders. All animals were undergoing clinical examination, laboratory analyses, and ultrasonographic examination. Results: Diseased cattle had monocytic leukocytosis as well as hypoproteinemia and hypoalbuminemia. The SI ileus of either proximal (n=12) or distal (n=15), intussusception (n=3), cecal, and/or colonal dilatation (n=10) were diagnosed by ultrasound and other diagnostic tools. Duodenum intussusception was imaged in cross-section as bull's eyes lesions. Animals with SI obstructions showed complete cessation (ileus with complete obstruction) or partial reduction of the peristaltic SI movement (ileus with partial obstruction), dilated duodenum (6.5-9.9 cm), and dilated jejunum and/or ileum (4.4-6.8 cm). Ultrasonography diagnosed SI ileus, due to either intestinal obstruction or peritonitis, and detected the ileus site, either proximal or distal. Cecal/colonal dilatation was detected using ultrasonography in which SI was not imaged and the peristaltic movements were completely reduced. The recorded intestinal disorders were associated with other disorders (e.g., liver cirrhosis or peritonitis). Conclusion: Ultrasonography played an important role in the differential diagnosis of intestinal disorders in cattle. Peritonitis between SI loops and cecal and/or colonal dilatation was also diagnosed.

Common Radiological Findings in Children with Suspected Foreign Body Inhalation

BACKGROUND: Foreign body inhalation is an emergency situation, affecting children mostly in first decade of life. An aspirated solid or semisolid object may lodge in the larynx or trachea may cause complete obstruction. Lesser degrees of obstruction or passage of the obstructive object beyond the carina can result in less severe signs and symptoms. Chronic debilitating symptoms with recurrent infections might occur with delayed extraction, or the patient may remain asymptomatic. Many aspirated foreign bodies are unexpectedly discovered, go undetected, or are misdiagnosed. In many cases with suspected foreign body radiological findings may reveal other findings e.g. emphysema, atelectasis, air trapping. OBJECTIVE: To determine the frequency of common radiological findings among children with suspected foreign body inhalation. MATERIAL AND METHODS: This cross-sectional descriptive study was conducted at Department of ENT, Khyber Teaching Hospital, Peshawar, from April 2017 to October 2017. In this study a total of 141 patients were observed. All patients were subjected to detailed history and clinical examination. X ray chest (AP and lateral views) of all the patients was performed to detect common radiological findings (Radio-opaque Foreign Body (FB), Pneumonia, Emphysema, atelectasis and Air Trapping). The demographic details like name, age, gender, address and contacts were recorded on a pre-designed proforma. RESULTS: In this study mean age was 8 years with SD ± 3.563. Sixty percent children were male while 40% children were female. Sixteen percent children had Radio opaque FB, 13% children had pneumonia, 28% had emphysema, 18% children had atelectasis while 25% had Air trapping. CONCLUSION: Our study concludes that the frequency of Radio opaque was 16%, pneumonia 13%, emphysema 28%, atelectasis 18%, Air trapping 25% among children with suspected foreign body inhalation. KEY WORDS: radiological findings, suspected foreign body inhalation, Pneumonia, Emphysema, atelectasis and Air Trapping

Application of Nutritional Support in the Comprehensive Treatment of Gastric Cancer: A Case Report

Objective To relieve long-term malnutrition caused by a malignant tumor affecting the pylorus and to prolong the patient survival. Methods A patient presented with complete pyloric obstruction due to pyloric tumors, and achieved good therapeutic effects through nutritional support and effective chemotherapy. Results After about 40 days of treatment, all physiological indicators were improving. After chemotherapy, the pyloric tumor shrank and the complete obstruction was relieved. The patient was able to eat and drink normally. Conclusion Nutritional support, combined with chemotherapy, may effectively treat complete pyloric obstruction caused by advanced tumors.

Management of inferior dislocation of a StopLoss Jones tube after conjunctivodacryocystorhinostomy

Persistent epiphora significantly worsens one’s quality of life. A commonly known method of treatment of complete obstruction of the lacrimal canaliculi is conjunctivodacryocystorhinostomy with placement of a glass Jones tube. Unfortunately, the use of such a prosthesis of the lacrimal tract often results in certain complications, the most frequent of which include extrusion or superior and inferior migration. For the last several years, a modified version of the Jones tube—the StopLoss Jones tube (SLJT)—has been available. It almost eliminates the possibility of extrusion. However, inferior migration still remains an important problem. When that happens, it is necessary to proceed surgically. In this paper, we describe an endoscopically-guided technique of management of an inferiorly dislocated SLJT.