QUestion 95

Question 1

inhalation of foreign body what is prevnention

Answer 1

• Prevention and good practice
  o PPE and rubber dam or throat pack/swab/sponge/gauze
  o Check all equipment is in good working order
  o Obtain informed consent
  o Where practicable treat in upright position
  o High volume suction and appropriate instruments for retrieval should be available
  o Check mouth/airway for any debris

Question 2

inhalation of foreign body what is initial management

Answer 2

• Initial management
  o If suspected ingestion, stop and keep calm. Do not move the patient. Check mouth and gently remove any debris, foreign objects or material with tweezers. Failing this, encourage patient to cough
  o Ask patient if they have swallowed or inhaled a foreign object
  o Immediate symptoms of ingestion – dysphagia, odynophagia, vomiting, retching, foreign body sensation, hyper salivation, retrosternal pain
  o If patient cannot reply and is choking, commence basic first aid and call for an ambulance
  o If patient unsure, search. Ask pt to stand up and search chair, bracket table, clothes and surroundings
  o Check suction tubing
  o If patient has swallowed foreign object less than 5cm, then reassure patient no further action required. If larger than 5cm, long, sharp, pointed and inflexible then refer to local A&E
  o Pt may only present with symptoms at a later time, if so, advise to attend A&E
  o Encourage patient to check stools
  o If patient has acute respiratory distress, call an ambulance
  o If patient can talk, assume it has been swallowed
  o If they have inhaled, transfer to local A&E for further investigation (bronchoscopy, endoscopy)
• Report in notes and DATIX