Abstract
Background
Tracheobronchial foreign body aspiration can cause mild symptoms but may also become
dangerous enough to cause death. Bronchoscopy is the first choice for the diagnosis
and the removal of aspirated foreign bodies. So, when bronchoscopy is not available,
the situation might get challenging.
Case Report
A 62-year-old man was waiting for emergent surgery for traumatic epidural hematoma
in the Emergency Department (ED). Endotracheal intubation was performed for surgery
and airway maintenance. However, oxygen saturation dropped and respiratory arrest
was expected. As emergent bronchoscopy could not be performed, the emergency physician
decided to irrigate the trachea by using 0.9% normal saline in the ED. After three
rounds of irrigation, vital signs including oxygen saturation improved and the patient
could undergo neurosurgical surgery. The patient was subsequently discharged with
improved health.
Why Should an Emergency Physician Be Aware of This?
Bronchoscopy is the first choice for the treatment and diagnosis in cases of bronchial
aspiration of blood, such as that caused by epistaxis. However, in emergency situations,
such as deteriorating vital signs due to aspiration of life-threatening amounts of
blood from epistaxis, using blind tracheal irrigation as an alternative tool when
bronchoscopy is not available can help in achieving clinically acceptable results.
Keywords
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Article info
Publication history
Published online: May 14, 2020
Accepted:
April 8,
2020
Received in revised form:
March 15,
2020
Received:
January 7,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
