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Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
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Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
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Tracheostomy suctioning is a critical procedure healthcare professionals perform to maintain a patent airway in patients with a tracheostomy tube. This procedure is necessary when secretions accumulate in the airway, causing respiratory distress. Here is a step-wise procedural guide for performing tracheostomy suctioning using an open system.
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Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
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A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
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A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
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Inhaled open safety pin: a challenging case.

Milan Sedhai1, Prashant Tripathi1

  • 1Department of ENT Head and Neck Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.

Oxford Medical Case Reports
|May 27, 2022
PubMed
Summary

Sharp metallic foreign body aspiration in children poses risks. Emergency bronchoscopic removal of an open safety pin in an 8-year-old girl was successful, preventing complications.

Area of Science:

  • Pediatric Otolaryngology
  • Emergency Medicine
  • Medical Case Reports

Background:

  • Foreign body aspiration in children, particularly sharp metallic objects, presents significant risks of morbidity and mortality.
  • Timely intervention is crucial, but bronchoscopic removal of such objects can be technically demanding for surgeons.

Observation:

  • An 8-year-old girl presented with throat pain and dysphagia after aspirating an open safety pin.
  • Radiographic imaging revealed a radio-opaque foreign body in the supraglottic region.
  • The foreign body was an open, sharp, metallic safety pin lodged between the arytenoids, extending into the subglottis and hypopharynx.

Findings:

  • Emergency direct laryngoscopy successfully removed the sharp metallic foreign body under general anesthesia.

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  • The surgical procedure was technically challenging due to the object's position and sharp nature.
  • The patient experienced no post-operative complications.

    • Implications:

    • This case highlights the successful emergency management of a life-threatening sharp metallic foreign body in a child.
    • Prompt diagnosis and intervention are critical for favorable outcomes in pediatric foreign body aspiration.
    • The case underscores the importance of specialized skills in bronchoscopic removal of challenging foreign bodies.