A 2 year old child with intercostal retraction and increasing cyanosis was brought with a history of foreign body aspiration. which might be lifesaving in this situation?
The child is presenting with cyanosis and intercostal retraction which indicates that the foreign body is lodged in the larynx. Initial management for a foreign body lodged in trachea/larynx is Heimlich's maneuver where a person stands behind the child and places his arms around his lower chest and gives four abdominal thrust. In infants, lying the child on its back on the adults knee and pressing firmly on the upper abdomen is the preferred maneuver. If Heimlich's maneuvre fails, cricothyrotomy or emergency tracheostomy should be done. Once acute respiratory emergency is over foreign body can be removed by direct laryngoscopy or by laryngofissure, if it is impacted. Tracheal and bronchial foreign bodies are removed by bronchoscopy with full preparation and under GA.
Oxygen through face mask
Heimlich's manoeuvre
Extra cardiac massage
Intracaridiac adrenaline