Today, a baby died in the hospital in Suining County, Xuzhou, Jiangsu Province, which has aroused widespread concern.
According to the notification, the 1-year-old and 5-month-old child swallowed a foreign body, and the family took half a pumpkin seed with a skin from his mouth and sent it to the hospital. The hospital's own treatment capacity is insufficient, but it did not use nucleic acid as a pretext to refuse treatment, but gave first aid measures such as oxygen inhalation, and urged the children's families to transfer six times.
However, due to various reasons, from the first notice of transfer at 21:00 that night to the departure of the child at 1:22 the next day, this process was delayed by more than four hours, which seriously affected the follow-up treatment and caused the child to lose his life.
Image source: Network screenshot
From a medical point of view, how can we understand this tragedy?
Airway foreign body
It's actually very complicated
Many parents think that it is not a big deal that their child chokes on something, or that it is all right to simply take out the foreign body. In today's news commentary, some people also asked, why is it that the seemingly simple airway foreign body, the emergency department is not able to deal with it?
In fact, the effects of foreign bodies entering the body can be very complex.
For example, the child in the news, after being cut out half a pumpkin seed, went to the hospital for treatment, and finally an accident occurred. The circular also said: "After asking for medical history, lung auscultation and other examinations, the receiving doctor preliminarily judged that it was a foreign body in the trachea." According to the news, there should also be foreign bodies stuck in the child's respiratory tract and not removed.
I don't know if any friends remember this: it's too thrilling! The doctor knelt down to blow oxygen for the 2-year-old boy and took out 36 pieces of peanut crushing. The situation of the two children may be somewhat similar: these fragmented foreign bodies are no longer in the main trachea, but have entered the left or right main bronchi.
One side of the trachea is blocked, will cause serious ventilation blood flow ratio abnormalities, simply put, that is, one side of the lungs can not be ventilated, but there is blood flow through, so the blood on this side is not oxygenated, which also causes the patient to be seriously hypoxic.
This hypoxia caused by the inability to ventilate one lung, while not immediately fatal (main airway obstruction can be immediately fatal), can also cause acute respiratory failure, which can lead to death within hours of the incident. You can't see that the child's vital signs have not deteriorated significantly, and you think that the foreign body has been completely discharged.
Children who have cleared foreign bodies from the airways by means of extraction, coughing, Heimlich first aid, and cardiopulmonary resuscitation still have to go to the hospital. This is not only because these methods have the potential to cause harm to the child, but also to ensure that the airway foreign body is completely cleaned up.
Children's airways are much thinner than those of adults, and the removal of these foreign bodies requires the use of specialized pediatric bronchoscopy. Not all hospitals are equipped with such equipment and have undergone capacity building accordingly, such as the ability to anesthetize infants and young children. Many of China's grassroots hospitals do not have this condition.
In this case, the doctor needs to choose a hospital with strong pediatric strength, if the doctor prompts that there is no ability to receive treatment, and a referral is required, it should be referred in time.
What should I do if my child chokes?
Here's a guide
If the child is conscious, can cough, and can cry, the foreign body in the child's mouth should not be picked at this time. Patients should be encouraged to continue coughing.
If the child is conscious, but can no longer cough, or cough silently, at this time should not pick the foreign body in the child's mouth, should take the Heimlich first aid method, of course, we should crouch down to implement:
Image source: Stand Cool Helo
If the child loses its response due to a foreign body in the airway, the foreign body in the child's mouth should not be picked at this time, but cardiopulmonary resuscitation should be started immediately. However, at this time, CPR should observe whether there is a foreign body in the patient's mouth before each artificial respiration, carefully remove the foreign body when it sees it, and implement artificial respiration without seeing the foreign body.
In addition, once again remind all friends that infant airway foreign bodies need to seek medical treatment in time. Even children who have cleared foreign bodies from the airways by cough, Heimlich first aid, and cardiopulmonary resuscitation must go to the hospital.
This is not only because these methods have the potential to cause harm to the child, but also because the airway foreign body has not been completely cleaned up! These can all be life-threatening!
This article is co-authored by experts
bibliography
LIU Xicheng. Development and prospect of pediatric respiratory endoscopy in mainland China[J]. Chinese Clinical Journal of Practical Pediatrics, 2015, 30(16):3
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Curator: ZYing | Executive Producer: Feidi, Erik