foreign bodies in larynx


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foreign bodies in larynx

An inhaled or aspirated solid object, such as a piece of meat, hard candy, safety pin, or coin, in the larynx. Any aspirated object poses an imminent risk of airway obstruction.

Symptoms

Symptoms may include coughing, choking, dyspnea, fixed pain, or loss of voice.

Patient care

If the patient is able to speak or cough, the rescuer should not interfere with the patient's attempts to expel the object. If the patient is unable to speak, cough, or breathe, the rescuer should apply the Heimlich maneuver 6 to 10 times rapidly in succession. Using air already in the lungs, the thrusts create an artificial cough to propel the obstructing object out of the airway. If the patient loses consciousness, carefully assist him or her to the ground in a supine (face up) position. Next the rescuer should begin CPR since compressions have been shown to be effective in clearing an obstruction. With each time attempt to ventilate, the rescuer should first look in the mouth to see if there is an object that can be pulled out of the airway with gloved fingers. Previously chest thrusts were taught for an obese or pregnant patient or a child with a foreign body airway obstruction. To simplify this procedure the Emergency Cardiac Care Guidelines 2005 recommend all patients receive chest compressions following CPR. For an infant, the rescuer uses back slaps before chest thrusts. Direct laryngoscopy and the use of Magill forceps may be required to remove a foreign object. If the object cannot be readily removed with these measures, an emergency cricothyrotomy, or emergency tracheotomy may be required. See: Heimlich maneuver

See also: larynx
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