Abstract
Background
Airway foreign body can be a life-threatening issue in pediatric and adult patients,
and the majority of these patients will first present to the emergency department.
Objective
This article provides a narrative review of the diagnosis and management of airway
foreign bodies for the emergency clinician.
Discussion
Foreign bodies in the upper and lower airways are potentially life threatening. This
affects all age groups but is more common in pediatric patients. A history of a witnessed
ingestion or aspiration event should raise the clinical suspicion for an aspirated
foreign body. Patients with upper-airway foreign bodies are more likely to present
in respiratory distress when compared with lower-airway foreign bodies, which often
present with more subtle signs. Stridor, drooling, and wheezing suggest respiratory
distress, but the presenting clinical picture is often unclear and may only include
a cough. Immediate intervention is required in the patient with hemodynamic instability
or respiratory distress. Airway management including laryngoscopy, fiberoptic bronchoscopy,
and cricothyrotomy may be needed in these patients, with the emphasis on removing
the obstructing foreign body and securing the airway. Specialist consultation can
assist in retrieving the foreign body and managing the airway. If the patient is stable,
imaging and specialist consultation for potential operating room intervention should
be considered.
Conclusions
An understanding of the presentation, evaluation, and management of the patient with
an airway foreign body is essential for emergency clinicians.
Keywords
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Article info
Publication history
Published online: December 17, 2022
Accepted:
December 13,
2022
Received in revised form:
November 3,
2022
Received:
May 17,
2022
Publication stage
In Press Uncorrected ProofIdentification
Copyright
Published by Elsevier Inc.
