Today, a baby in Suining County, Xuzhou, Jiangsu died in the hospital, causing widespread concern.
According to the report, the 1-year-old, 5-month-old child swallowed a foreign body, and his family took half a pumpkin seed with the skin out of his mouth and sent him to the hospital. The hospital’s own treatment capacity was insufficient, but it did not refuse the diagnosis under the pretext of nucleic acid, but gave first aid measures such as oxygen inhalation, and urged the family of the child to transfer to the hospital six times.
However, due to various reasons, from the first notification of transfer at 21:00 that night to the discharge of the patient at 1:22 the next day, the process was delayed for more than four hours, which seriously affected the Subsequent treatment resulted in the death of the patient.
Image source: Internet screenshot
How should we understand this tragedy from a medical perspective?
Airway foreign body
It’s really complicated
Many parents don’t think it’s a big deal for their child to choke on something, or think that as long as the foreign object is removed, everything will be fine. In today’s news commentary, some people also asked why the seemingly simple foreign body in the airway is not capable of being treated in the emergency department?
Actually, the effects of foreign objects entering the body can be very complex.
For example, the child in the news went to the hospital after being cut out of half a pumpkin seed, but finally had an accident. The report also said: “The receiving doctor initially judged that it was a foreign body in the trachea after inquiring about the medical history, lung auscultation and other tests.” According to the news, there should be a foreign body stuck in the child’s respiratory tract, which has not been removed.
I don’t know if there are any friends who remember this: it’s too thrilling! The doctor knelt down and gave oxygen to a 2-year-old boy, and actually took out 36 pieces of peanuts. The two children’s situation may be somewhat similar: the fragmented foreign bodies are no longer in the main trachea, but into the left or right main bronchus.
The trachea on one side is blocked, which will cause serious abnormal ventilation and blood flow ratio. The blood on the side is not oxygenated, which causes severe hypoxia in the patient.
This kind of hypoxia caused by the inability to ventilate one side of the lung is not immediately fatal (the main airway obstruction will be immediately fatal), but it can also cause acute respiratory failure. cause death within hours. If you can’t see that the child’s vital signs have not deteriorated significantly, it is assumed that the foreign body has been completely expelled.
Children whose airway foreign bodies have been removed by methods such as gouging, coughing, Heimlich maneuver, CPR, etc. must still go to the hospital. This is not only because these methods have the potential to cause harm to the child, but also to ensure that the foreign body in the airway is completely cleared.
Children’s airways are much thinner than adults, and special pediatric bronchoscopes are required to remove these foreign bodies. Not all hospitals are equipped with this equipment and have built the capacity, such as the ability to anesthetize infants and young children. Many primary hospitals in China do not have such conditions.
In this case, it is necessary to choose a hospital with strong paediatric capacity for medical treatment. If the doctor indicates that there is no ability to receive patients and needs to be referred, it should be referred in time.
What if my child chokes?
This is a guide
If the child is conscious, coughing, and crying, the foreign object in the child’s mouth should not be picked at this time. Instead, patients should be encouraged to continue coughing.
If the child is conscious, but can no longer cough, or the cough is silent, the foreign body in the child’s mouth should not be picked at this time, and the Heimlich maneuver should be used. Of course, we should squat Implemented below:
Image source: Zhanku Hailuo
If the child becomes unresponsive due to a foreign body in the airway, the foreign body in the child’s mouth should not be picked at this time, but CPR should be started immediately. However, in CPR at this time, it is necessary to observe whether there is any foreign body in the patient’s mouth before each artificial respiration.
In addition, I would like to remind all friends once again that foreign bodies in the airway of infants and young children need to seek medical attention in time. Even children whose airway foreign bodies have been cleared by coughing, Heimlich maneuver, cardiopulmonary resuscitation, etc. must go to the hospital.
It’s not just because these methods have the potential to cause harm to the child, it’s also possible that the foreign body in the airway is not completely cleared! These can be life-threatening!
Partnering experts for this article
References
[1] Liu Xicheng. The development and prospect of pediatric respiratory endoscopy in my country [J]. Chinese Journal of Practical Pediatrics, 2015, 30(16):3
Planning
Planner: ZYing | Producer: Feidi, Erik