Tag Archives: emergency

Paediatric foreign body aspiration – recipe for EUA

Gas induction. Maintain spontaneous ventilation. Adequate depth of anaesthesia

(+/- check ventilation – risk of pushing FB distally. Avoid insufflation of stomach)

Direct laryngoscopy

Spray cords with lignocaine

Insert uncuffed nasal (standard) ETT to level just above cords

+/- close mouth as required

Spontaneous ventilation of O2+anaesthetic vapour. PEEP on T-peice

Also see: https://anaesthesiaonreflection.wordpress.com/2014/12/05/paediatric-airway-surgery-recipe/

NB

Remember basic manoeuvres e.g. Abdominal thrusts, Heimlick Manoeuvre, back blows.
In the event of cardiac arrest CPR/chest compressions may dislodge the foreign body.

Critical Incident reflection

Misc learning points

delegate a scribe during the event if possible

notes – should be comprehensive, contemporaneous, accurate. MDT

Involve seniors & MDT

Breaking bad news with family: Team approach. Be honest & open. Avoid information overload, may need second meeting. Single spokesperson. Reassure pt not in pain or aware.

Report incident

Debrief of whole team after the event. Ideally with somebody adequately trained and ‘3rd party’

Independent investigator

Discuss with MPS/MDU if necessary

Refs:

http://www.aagbi.org/sites/default/files/catastrophes05.pdf

http://ceaccp.oxfordjournals.org/content/early/2013/08/28/bjaceaccp.mkt050.full.pdf+html