Peanut Mika pediatric respiratory tract Zhuzhou Central Hospital successfully treated

Red Net Moment, February 18 (Correspondent He Xuan, Deng Yaping, Peng Peng) Every year around the Spring Festival, the hospital will always accept and treat small patients who have a foreign body mistakenly entering the respiratory tract.

Xiaobei, whose home is in the county town, is one year and five months old, and looks white and pure, which is very cute. On the evening of January 5, 2022, Xiao Bei suddenly had shortness of breath and purple lips after stealing peanuts and rice at home, and his condition was very critical. Xiao Bei's mother and grandfather quickly took him to the local hospital, but they were told that the hospital had limited medical means and no conditions to give him treatment, and suggested that he be transferred to the hospital as soon as possible. They panicked even more and drove non-stop to Zhuzhou Central Hospital, anxious along the way.

At about 12 o'clock in the evening, Xiao Bei was finally sent to the Department of Otolaryngology, Head and Neck Surgery of Zhuzhou Central Hospital. CT lung suggests right parapharyngeal, right clavicle fossa, mediastinum, and bilateral hilar piscene, narrowing of some bronchial compression, and obstructive emphysema in the left lung.

Department director Liu Hanbo led the duty physician He Xuan to immediately open a green channel, with the full cooperation of anesthesiologist Yi Hu and operating room nurse Li Feng, the rescue team composed of many people quickly entered the surgical state and performed a general anesthesia lower tracheobronchioscopy on Xiaobei. Because of the poor tolerance of the child at a young age, coupled with the serious pulmonary obstruction, the intraoperative endoscopic operation is very difficult, the breathing maintenance is extremely difficult, and the blood oxygen and heart rate drops have occurred many times, close to zero. After the team's rigorous and meticulous operation, a peanut kernel was finally removed from the left and right bronchial tubes, which made Xiaobei turn the crisis into safety.

Coincidentally, Xiaojin, who lives in Hetang District, is only 1 year old and 10 months old. Chinese New Year's Eve, every household tea table is full of nuts, nuts and biscuits, Grandpa while sniffing peanuts while watching the Spring Festival Gala, Xiao Jin is hungry at the tea table, Grandpa looks at his appearance and can't bear it, so he fed him a peanut, who knows he just ate the peanut into his mouth, suddenly his face was swollen red, coughing constantly, and accompanied by vomiting. The family knew that something was wrong, and Dad rushed to the hospital as soon as he hugged it.

On this celebratory night when thousands of families should be reunited, the Xiaojin family did not feel the joy of the festival at all. After rushing to the Department of Otorhinolaryngology, Head and Neck Surgery of Zhuzhou Central Hospital, an emergency lung CT was performed to suggest a left main bronchial foreign body. At this time, he was short of breath, and his parents also had a heart hanging over it. Dr. Deng Yaping, who was on duty Chinese New Year's Eve night, quickly gave him ECG monitoring, oxygen inhalation, and prepared bedside tracheotomy to open the bag.

Because Xiao Jin's last time eating was at 11:00 p.m. and drank 200 ml of milk, and tracheobronchial microscopy and foreign body removal required general anesthesia, the operation was unable to perform endotracheal intubation because of the operation in the trachea, if the fasting time is insufficient, the gastric contents reflux during the anesthesia process is very easy to be inhaled into the lungs, causing greater risk. On the one hand, the foreign body that may cause Xiaojin to suffocate at any time needs to be removed as soon as possible, on the other hand, the risk of anesthesia is also extremely high if the fasting time is not enough, and the situation is suddenly in a dilemma. Xu Wei, the anesthesiologist on duty that night, rushed to his ward for on-site assessment, and at the same time actively communicated with parents and finally reached an agreement, the situation allowed, try to meet the fasting time, the situation has changed, and no matter how big the risk is, it will be operated on immediately.

Fortunately, during the six-hour monitoring, Xiao Jin's vital signs were relatively stable, and before the light of the day, he was pushed into the operating room. During the operation, his blood oxygen value also fell for a while, his face turned blue instantly, and the surgical team composed of Deputy Chief Physician Peng Peng, Chief Physician Peng Zenglong, Xu Wei Anesthesiologist, Dr. Deng Yaping and Nurse Yang Xiaojuan successfully clipped out the deadly peanut rice in Xiao Jin's left lung.

Two sleepless nights, two successful rescues, in exchange for the happiness and peace of two families! The sense of acquisition and satisfaction of the medical profession is once again written on the tired and determined faces of every member of the MDT team in the treatment of respiratory foreign bodies in Zhuzhou Central Hospital.

Respiratory foreign bodies are very dangerous

Xiao Bei and Xiao Jin were lucky, and after rescuing them, they all turned the corner. However, when a respiratory foreign body accident occurs, it is not always so lucky. According to a sample survey, airway foreign body obstruction is the leading cause of death from asphyxia in children, with the highest incidence among children aged 0-4 years. More than 3,000 children die each year from foreign bodies in the airways. This is because infants and young children have incomplete teeth development and throat protective reflex function, weak cough ability, coupled with the nature of curiosity, often like to mouth items and food for a long time, once there is crying and laughing or falling, it is very easy to appear aspiration, foreign bodies into the lungs but can not cough out on their own, long-term lack of oxygen is very likely to cause the most serious consequences.

Clinical manifestations of foreign bodies in the respiratory tract vary

When the foreign body first enters the tracheobronchial bronchi, it will immediately cause a severe cough, hold your breath, and even suffocate, and as the foreign body goes deeper and stabilizes, the symptoms gradually ease. Thus, the foreign body remaining in the trachea or bronchi for a period of time may be asymptomatic or only mild cough and stridor, especially if the foreign body is small and stays in the small bronchi, there may be no symptoms. At this time, it is often easy to be ignored by parents. As the foreign body persists for an extended period of time, different types of foreign bodies constantly stimulate the respiratory mucosa to produce different degrees of inflammatory reactions (nuts such as peanuts, melon seeds, almonds and other foods contain fatty acids caused by more inflammation) Secondary infections cause recurrent fever, cough, sputum and other symptoms. If the foreign body has not been removed in time, it is further combined with bronchitis, pneumonia, emphysema, atelectasis, pneumothorax, mediastinum or subcutaneous emphysema, lung abscess, hemoptysis, respiratory failure, heart failure and the like. Therefore, as long as a foreign body enters the tracheobronchia, it is very dangerous at different stages and may take his or her weak life at any time. Therefore, as long as the child has a history of foreign body inhalation, regardless of whether there are other typical signs and symptoms, parents should not be lucky, and it is a wise choice to seek medical treatment in time.

The "Heimlich Law" can save lives at key moments

However, if the foreign body entering the airway is larger, the airway can be completely blocked, resulting in the child's "three noes": can not cough, can not breathe, can not make sounds. Or although the foreign body is small, it has been blocked in the trachea, and although it has been severely coughed, it cannot be shocked out of the airway, resulting in glottis edema or laryngeal spasm. Both of these conditions are very dangerous, and will progress to facial bruising, irritability, loss of consciousness, cardiac arrest in a short period of time, even if it is sent to the hospital in time, the brain is also seriously hypoxic, and the success rate of treatment is very low. It is particularly important to learn and master a "Heimlich method". Here's how:

1. For infants under 1 year of age, one hand fixes the baby's jaw, so that the face is facing down, the head is low and the hips are high; the root of the other hand is continuously tapped on the interscapular area 5 times.

Then flip the baby into a face up, head low hip high, check the mouth for foreign body, such as no foreign body, immediately flip the baby's body into a supine position, head low hip high, with the food, middle finger continuous impact of the two nipples just below the line 5 times.

The two methods alternate repeatedly until the foreign body is discharged.

2. For children aged 1-8 years, regardless of whether the consciousness is clear or not, the rescuer sits on a chair or kneels on one leg, puts the child's abdomen on his thigh, lowers his head, raises his hips, and continuously slaps the child's shoulder blades with the root of his palm. Every 5 times the back is patted, check once for the foreign body to be discharged.

Doctor's Reminder:

1. Within the age of five, do not feed your child food that is too big or too hard (such as peanuts, nuts, melon seeds).

2. Infants and young children have a large amount of activities and strong curiosity, parents must manage small toys such as small beads, buttons, parts, etc., small snacks such as peanuts, fruit cores, raisins, jelly, etc. Pay attention to whether the toy has small attachments that are easy to fall off, so that children do not fall off when they bite the toy.

3. Avoid teaching children and chasing feeding, avoid crying and making a fuss when eating, eat while playing, and do not scold children when eating, and develop good feeding habits. Children should not be given nasal irrigation.

4. Educate children not to put toys in their mouths, and correctly guide them to spit themselves out, and avoid intimidation or forced finger digging.

5. For children with general anesthesia surgery and coma, pay attention to the presence of loose teeth; tilt the head sideways to prevent vomit from being inhaled into the airway by mistake.