Aerodigestive Foreign Bodies

6.1.1 What are the risk factors for foreign body ingestion (FB) and the most common types of FBs in the airway and esophagus.

6.1.2 What are the most common locations for esophageal and airway FBs. 

http://portal.entnet.org/images/COCLIA/2011-2012%20updates/COCLIA%20Media/Aerodigestive%20Foreign%20Bodies/Aerodigestive%20Foreign%20Bodies-Q2.jpg

6.1.3 Discuss the symptoms and signs of airway and esophageal FBs.

6.1.4 Describe the role of radiographs in management of both esophageal and airway FB. 

http://portal.entnet.org/images/COCLIA/2011-2012%20updates/COCLIA%20Media/Aerodigestive%20Foreign%20Bodies/Aerodigestive%20Foreign%20Bodies-Q4.jpg

6.1.5 What is the role of bronchoscopy/esophagoscopy in the management of aerodigestive tract foreign bodies? What are the indications for upper aerodigestive tract endoscopy?

6.1.6 A 2-year-old boy is seen chewing an almond. He has a coughing episode and the father attempts a finger sweep. After a paroxysmal cough, he has improved over 20 minutes. In the ER, he is afebrile, comfortable, and with good saturations. Breath sounds reveal occasional unilateral wheezing. X-rays are unremarkable. How would you manage this patient?

6.1.7 A child swallows a safety pin that is now lodged in the mid-esophagus. Discuss the management. What are the techniques for removing an open safety pin from the esophagus?

6.1.8 A 3-year-old girl chokes and coughs while eating a piece of carrot. After a few minutes, her symptoms improve. She is seen in the ED, where she has the following inspiratory/expiratory chest films. What is the most likely location for the foreign body? How would you manage the patient?

http://portal.entnet.org/images/COCLIA/2011-2012%20updates/COCLIA%20Media/Aerodigestive%20Foreign%20Bodies/Aerodigestive%20Foreign%20Bodies-Q8.jpg

6.1.9 Discuss anesthesia techniques in the management of aerodigestive tract foreign bodies.

Fidkowski CW, Zheng H, Firth PG. The anesthetic considerations of tracheobronchial foreign bodies in children: A literature review of 12,979 cases. Anesth Analg. 2010 Oct;111(4):1016-2Epub 2010 Aug 27. PMID:20802055

6.1.10 What is the safest method for removal of esophageal foreign bodies? What techniques are less safe or potentially dangerous?

6.1.11 An 18-month-old boy is transferred from the emergency room from an urgent care clinic with a "coin" in the esophagus. There was no witnessed coin ingestion, but he has been drooling and not eating or drinking for the past day. He had the following chest x-ray. How would you proceed? 

http://portal.entnet.org/images/COCLIA/2011-2012%20updates/COCLIA%20Media/Aerodigestive%20Foreign%20Bodies/Aerodigestive%20Foreign%20Bodies-Q11.jpg

6.1.12 Discuss the management of button battery ingestion.

6.1.13 Explain strategies for prevention of aerodigestive tract foreign bodies in children and discuss the role of health care providers in prevention.

http://portal.entnet.org/images/COCLIA/2011-2012%20updates/COCLIA%20Media/Aerodigestive%20Foreign%20Bodies/Aerodigestive%20Foreign%20Bodies-Q13.jpg

Committee on Injury, Violence, and Poison Prevention. Prevention of choking among children. Pediatrics. 2010 Mar;125(3):601-Epub 2010 Feb 22. PMID:20176668