challenge
Foreign Body Aspirations
Build the Illness Script
Learning Objective: After completing this activity: We should be able to understand the difference in presentation of foreign body aspiration (upper airway vs lower airway). We should be able to understand the difference in treatment of the presentation (upper airway vs lower airway) as well as in patients that are responsive vs. unresponsive.
We aim to learn this topic because we are presented with a case of foreign body aspiration. Understanding the different clinical presentations based on the location of aspiration allows us to recognize the condition promptly, appreciate that foreign body aspiration can present in multiple ways, and apply a range of appropriate management and treatment strategies in clinical practice.
start challenge
Upper right lobe affected in bedridden patiens
Children < 3 years; with peak incidence at 1 - 2 years.
Mortality - Highest in patients 80 - 90 years of age.
Dysphagia; intoxication; altered mental status; neuromuscular disease
Complete obstruction --> atelectasis distal to obstruction
Although not frequent may lodge in the larynx or trachea
Right main bronchus is more often affected than the left
Partial obstruction --> formation of a ball valve obstruction with air trapping.
Aspiration of nuts, raisins, coins, toys - occur during chewing
Bronchi obstruction is slightly less severe than upper airway obstructions.
Etiology
Demographics
Pathophysiology
Purulent or mucopurulent sputum
Chocking, coughing, acute dyspnea, hoarsness
Wheeze and fever
Ausculatation; lung and heart
Hyperresonace on the affected side
Symptoms may occcurs days or weeks later
Stridor; sternal retraction; difficulty swallowing, drooling
Absent breath sounds in affected lung field; wheezing
Inability to speak, cry out, or cough; use of accessory muscles of respiration
Agitation followed by loss of consciousness; cyanosis
Symptoms
Physical Exams
Flexible bronchoscopy
Chest x-ray (lateral and expiratory views)
Rigid bronchoscopy
CT chest without contrast
Laryngoscopy
Surgical management --> Thoracotomy
Nasal Endoscopy
If visible, the object is grasped and removed with forceps
Neck x-ray (lateral view)
Bronchoscopy
Imaging/Diagnostic Tools
Treatment
Start CPR
Rigid or flexible bronchoscopy
Chest thrusts/abdominal thrusts
Laryngoscopy guided dislodging of foreign body
Coughing to dislodge the FB
Nasal endocopy guided dislodging of foreign body
Oxygen therapy and IV antibiotics
Emergency surgery
Management of unresponsive patient
Management of responsive patient
Questions?
Thank you for participating
I hope you found this helpful. Great job!
Foreign Body Aspirations
Makeda Asare
Created on February 5, 2026
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Transcript
challenge
Foreign Body Aspirations
Build the Illness Script
Learning Objective: After completing this activity: We should be able to understand the difference in presentation of foreign body aspiration (upper airway vs lower airway). We should be able to understand the difference in treatment of the presentation (upper airway vs lower airway) as well as in patients that are responsive vs. unresponsive.
We aim to learn this topic because we are presented with a case of foreign body aspiration. Understanding the different clinical presentations based on the location of aspiration allows us to recognize the condition promptly, appreciate that foreign body aspiration can present in multiple ways, and apply a range of appropriate management and treatment strategies in clinical practice.
start challenge
Upper right lobe affected in bedridden patiens
Children < 3 years; with peak incidence at 1 - 2 years.
Mortality - Highest in patients 80 - 90 years of age.
Dysphagia; intoxication; altered mental status; neuromuscular disease
Complete obstruction --> atelectasis distal to obstruction
Although not frequent may lodge in the larynx or trachea
Right main bronchus is more often affected than the left
Partial obstruction --> formation of a ball valve obstruction with air trapping.
Aspiration of nuts, raisins, coins, toys - occur during chewing
Bronchi obstruction is slightly less severe than upper airway obstructions.
Etiology
Demographics
Pathophysiology
Purulent or mucopurulent sputum
Chocking, coughing, acute dyspnea, hoarsness
Wheeze and fever
Ausculatation; lung and heart
Hyperresonace on the affected side
Symptoms may occcurs days or weeks later
Stridor; sternal retraction; difficulty swallowing, drooling
Absent breath sounds in affected lung field; wheezing
Inability to speak, cry out, or cough; use of accessory muscles of respiration
Agitation followed by loss of consciousness; cyanosis
Symptoms
Physical Exams
Flexible bronchoscopy
Chest x-ray (lateral and expiratory views)
Rigid bronchoscopy
CT chest without contrast
Laryngoscopy
Surgical management --> Thoracotomy
Nasal Endoscopy
If visible, the object is grasped and removed with forceps
Neck x-ray (lateral view)
Bronchoscopy
Imaging/Diagnostic Tools
Treatment
Start CPR
Rigid or flexible bronchoscopy
Chest thrusts/abdominal thrusts
Laryngoscopy guided dislodging of foreign body
Coughing to dislodge the FB
Nasal endocopy guided dislodging of foreign body
Oxygen therapy and IV antibiotics
Emergency surgery
Management of unresponsive patient
Management of responsive patient
Questions?
Thank you for participating
I hope you found this helpful. Great job!