For foreign body causing sudden choking, most appropriate first line of management is?
ANSWER: (B) Heimlich maneuverREF: Dhingras 4th ed p. 257Management of Laryngeal foreign body:A large bolus of food/ foreign body obstructed above the cords may make the patient totally aphonic, unable to cry for help. He may die of asphyxia unless immediate first aid measures are taken.H eimlichJs maneuvers: S udden thrust dire cte d up wards and backwards, b elo w the epigastrium, squeezes the air from the lungs, sufficient to dislodge a foreign body.Cricothyrotomy or emergency tracheostomy should be done if Heimlich's maneuvers fails.Once acute respiratory emergency is over, foreign body can be removed by direct laryngoscopy or by laryngofissure, if found impactedManagement of Tracheal and bronchial foreign bodies:Bronchoscopy under general anesthesia. Emergency removal of these foreign bodies is not indicated unless there is airway obstruction or they are of the vegetable nature (e.g. seeds) and likely to swell up. Methods to remove tracheobronchial foreign body:Conventional rigid bronchoscopy.Rigid bronchoscopy with telescopic aid.Bronchoscopy with C-arm fluoroscopy.Use of Dormia basket or Fogartys balloon for rounded objects.Tracheostomy first and then bronchoscopy through the tracheostome.Thoracotomy and bronchotomy for peripheral foreign bodies.Flexible fiber optic bronchoscopy in selected adult patients.
Tracheostomy
Heimlich maneuver
Airway insertion
Laryngoscopy
Fundamental Concepts