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Ko TK, Tan DJY, Fan KS. Evaluation of the Quality and Readability of Web-Based Information Regarding Foreign Bodies of the Ear, Nose, and Throat: Qualitative Content Analysis. JMIR Form Res 2024; 8:e55535. [PMID: 39145998 DOI: 10.2196/55535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Foreign body (FB) inhalation, ingestion, and insertion account for 11% of emergency admissions for ear, nose, and throat conditions. Children are disproportionately affected, and urgent intervention may be needed to maintain airway patency and prevent blood vessel occlusion. High-quality, readable online information could help reduce poor outcomes from FBs. OBJECTIVE We aim to evaluate the quality and readability of available online health information relating to FBs. METHODS In total, 6 search phrases were queried using the Google search engine. For each search term, the first 30 results were captured. Websites in the English language and displaying health information were included. The provider and country of origin were recorded. The modified 36-item Ensuring Quality Information for Patients tool was used to assess information quality. Readability was assessed using a combination of tools: Flesch Reading Ease score, Flesch-Kincaid Grade Level, Gunning-Fog Index, and Simple Measure of Gobbledygook. RESULTS After the removal of duplicates, 73 websites were assessed, with the majority originating from the United States (n=46, 63%). Overall, the quality of the content was of moderate quality, with a median Ensuring Quality Information for Patients score of 21 (IQR 18-25, maximum 29) out of a maximum possible score of 36. Precautionary measures were not mentioned on 41% (n=30) of websites and 30% (n=22) did not identify disk batteries as a risky FB. Red flags necessitating urgent care were identified on 95% (n=69) of websites, with 89% (n=65) advising patients to seek medical attention and 38% (n=28) advising on safe FB removal. Readability scores (Flesch Reading Ease score=12.4, Flesch-Kincaid Grade Level=6.2, Gunning-Fog Index=6.5, and Simple Measure of Gobbledygook=5.9 years) showed most websites (56%) were below the recommended sixth-grade level. CONCLUSIONS The current quality and readability of information regarding FBs is inadequate. More than half of the websites were above the recommended sixth-grade reading level, and important information regarding high-risk FBs such as disk batteries and magnets was frequently excluded. Strategies should be developed to improve access to high-quality information that informs patients and parents about risks and when to seek medical help. Strategies to promote high-quality websites in search results also have the potential to improve outcomes.
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Affiliation(s)
- Tsz Ki Ko
- Department of Surgery, Royal Stoke Hospital, Stoke, United Kingdom
| | | | - Ka Siu Fan
- Department of Surgery, Royal Surrey County Hospital, Guildford, United Kingdom
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Alshaikh AA, Alhelali A, Hassan AA, Asiri MYA, Bukhari LKT, Hassan AAH, Hassan AAH, Alqahtani RSH, AlQahtani RY, Ghazy RM. Community experience and awareness regarding foreign body aspiration in Asir region, Kingdom of Saudi Arabia. Medicine (Baltimore) 2024; 103:e38869. [PMID: 39093731 PMCID: PMC11296466 DOI: 10.1097/md.0000000000038869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 06/19/2024] [Indexed: 08/04/2024] Open
Abstract
Foreign body aspiration (FBA) is a serious preventable pediatric health problem and one of the main causes of accidental death in children. Although unusual in adults, it is often overlooked as a cause of airway obstruction with serious consequences. This study assessed awareness and previous FBA experiences in the Asir community, Kingdom of Saudi Arabia. Using validated questionnaire, an annonymous online survey was conducted among 870 people aged 18 years and above. The questionnaire was used to collect data about the personal and sociodemographic characteristics of the respondents, as well as their experiences with FBA, and participants' knowledge and perceived seriousness of FBA. The level of knowledge was deemed good if the score ranged between 60% and 100%, and bad if the score fell below 60%The level of knowledge was deemed good if the score ranged between 60% and 100%, and bad if the score fell below 60%. The majority of the participants (79.7%) were females, 48.1% were aged 18 to 30 years, 72.9% had university degree, 30.6% were students, 26.9% worked in the educational sector, 43.6% reported monthly income of <5000 Saudi Riyals and 19.8% of them identified themselves as healthcarepractitioners. Although the community experience with FBA was considerably high (70.6%) among the study participants, their awareness levels about FBA were deficient. Only 24.7% of the respondents had good knowledge of FBA. Older age, being a health practitioner, and perceiving FBA as a serious incident were significantly associated with good knowledge (P < .001). The findings of this study indicate an urgent need to raise community awareness of FBA. To reduce FBA morbidity and mortality, health education efforts in community and healthcare settings are required to educate people about the seriousness and importance of early diagnosis and management of the condition.
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Affiliation(s)
- Ayoub Ali Alshaikh
- Family & Community Medicine Department, King Khalid University, College of Medicine Abha, Abha, Saudi Arabia
| | - Abdullah Alhelali
- Abha Children Hospital, Aseer Central Hospital, Head of Airway/Laryngology Unit – Aseer, Central Hospital, Abha, Saudi Arabia
| | - Abdulrahim Ali Hassan
- Otorhinolaryngology, Head and Neck Surgery, Armed Forced Hospital Southern Region, Khamis Mushait, Saudi Arabia
| | | | | | | | | | | | | | - Ramy Mohamed Ghazy
- Family & Community Medicine Department, King Khalid University, College of Medicine Abha, Abha, Saudi Arabia
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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3
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Thirunavukkarasu A, Alanazi AR, Al-Rasheedi AN, Alruwaili DK, Abdel-Salam DM, Alriwely NS, Alruwaili AFJ, Alanazi AAZ, Alruwaili SFO, Alruwaili ARR. Assessment of knowledge, attitude, and practice toward first aid management of choking hazards among Eastern Province Saudi adults: an observational study. Front Public Health 2024; 12:1376033. [PMID: 38939560 PMCID: PMC11208311 DOI: 10.3389/fpubh.2024.1376033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 06/03/2024] [Indexed: 06/29/2024] Open
Abstract
Background and aim Childhood choking is a global health concern that mainly affects children under the age of 5 years. The parent's and caretaker's responsibility is critical in the children's lives and can potentially influence the result of at-home injuries such as choking. We aimed to assess the knowledge, attitude, practice, and associated factors of first aid management toward choking hazards among Saudi adults from the Eastern Province. Methods The present analytical study was carried out among 390 Saudi adults attending different primary health centers in the Eastern Province of Saudi Arabia. We used a standard and validated data research topic tool to assess knowledge, attitude, and practice. Spearman's correlation was applied to determine the correlation between each section, while binomial logistic regression analysis was applied to identify the associated factors. Results We observed knowledge, attitude, and practice scores in 43.3, 38.9, and 36.4% of the participants, respectively. Furthermore, positive correlations between knowledge and attitude (rho = 0.42, p = 0.001), between knowledge and practice (rho = 0.57, p = 0.001), and between attitude and practice (rho = 0.41, p = 0.001) were revealed in our survey. The knowledge of the participants was significantly higher with the age group of 30-40 years [adjusted odds ratio (AOR) = 3.67 (1.94-4.65), p = 0.001] and participants who received training in first aid management [AOR = 1.64 (1.12-2.49), p = 0.037]. This study found that males [AOR = 0.36 (0.21-0.63), p = 0.001] and those working in the private sector [AOR = 0.61 (0.31-0.87), p = 0.018] had significantly lower attitudes. Conclusion Our results underscore the importance of continuous health education initiatives and training courses at primary health care centers regarding first aid management of choking hazards to improve awareness and practices. Furthermore, we recommend prospective multicenter studies to address region-specific knowledge gaps.
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Affiliation(s)
| | - Abdulrahman Raji Alanazi
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | - Abdullah N. Al-Rasheedi
- Department of Otolaryngology and Head and Neck Surgery, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | | | - Doaa Mazen Abdel-Salam
- Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
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4
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Zhang SJ, Lin MY, Zhou M, Dan YZ, Gu HB, Lu GL. Hypoxaemia risk in pediatric flexible bronchoscopy for foreign body removal: a retrospective study. BMC Pediatr 2024; 24:359. [PMID: 38783220 PMCID: PMC11112929 DOI: 10.1186/s12887-024-04836-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/16/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Hypoxemia represents the most prevalent adverse event during flexible bronchoscopy procedures aimed at foreign body retrieval in pediatric patients; if not expeditiously managed, it carries the potential for cardiac or respiratory arrest. The specific risk factors contributing to the occurrence of hypoxemia during foreign body FB removal via bronchoscopy have yet to be definitively established. METHODS This retrospective study included a cohort of 266 pediatric subjects from January 1, 2015, to December 31, 2022, who underwent flexible bronchoscopy for the purpose of FB extraction. In this cohort, the supraglottic airway was used to connect the anesthesia apparatus during the removal procedure. RESULTS In total, 45 of the pediatric patients (16.9%) experienced episodes of hypoxemia during the FB removal procedure. Multivariate analysis revealed that the following factors were significantly associated with the occurrence of hypoxemia: an operation time exceeding 60 min (odds ratio [OR] 8.55; 95% confidence interval [CI] 3.82-19.13), a maximum diameter exceeding 7 mm (OR 5.03; 95% CI, 2.24-11.29), and the presence of radiological evidence indicating pneumonia (OR 2.69; 95% CI, 1.27-5.69). CONCLUSION During flexible bronchoscopy procedures aimed at FB removal in pediatric patients, there is an increased susceptibility to hypoxemia. Factors including extended operation duration, larger FB dimensions, and radiographic evidence suggestive of pneumonia significantly contribute to a heightened risk of hypoxemia.
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Affiliation(s)
- Su-Jing Zhang
- College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Department of Anesthesiology, Fujian Children's Hospital(Fujian Branch of Shanghai Children's Medical Center), Fujian Key Laboratory of Women and Children's Critical Diseases ReseFujian Medical Universityarch, Fuzhou, China
- Department of Anesthesiology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Min-Yi Lin
- College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Department of Anesthesiology, Fujian Children's Hospital(Fujian Branch of Shanghai Children's Medical Center), Fujian Key Laboratory of Women and Children's Critical Diseases ReseFujian Medical Universityarch, Fuzhou, China
| | - Min Zhou
- College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Department of Anesthesiology, Fujian Children's Hospital(Fujian Branch of Shanghai Children's Medical Center), Fujian Key Laboratory of Women and Children's Critical Diseases ReseFujian Medical Universityarch, Fuzhou, China
- Department of Anesthesiology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Ying-Zhi Dan
- College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Department of Anesthesiology, Fujian Children's Hospital(Fujian Branch of Shanghai Children's Medical Center), Fujian Key Laboratory of Women and Children's Critical Diseases ReseFujian Medical Universityarch, Fuzhou, China
- Department of Anesthesia, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hong-Bin Gu
- College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Department of Anesthesiology, Fujian Children's Hospital(Fujian Branch of Shanghai Children's Medical Center), Fujian Key Laboratory of Women and Children's Critical Diseases ReseFujian Medical Universityarch, Fuzhou, China
- Department of Anesthesia, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Guo-Lin Lu
- College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Department of Anesthesiology, Fujian Children's Hospital(Fujian Branch of Shanghai Children's Medical Center), Fujian Key Laboratory of Women and Children's Critical Diseases ReseFujian Medical Universityarch, Fuzhou, China.
- Department of Anesthesiology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.
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Sezer HF, Eliçora A, Topçu S. Foreign body aspirations with rigid bronchoscopy and esophagoscopy in children. TURK GOGUS KALP DAMAR CERRAHISI DERGISI 2024; 32:S55-S59. [PMID: 38584785 PMCID: PMC10995683 DOI: 10.5606/tgkdc.dergisi.2024.25688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 11/29/2023] [Indexed: 04/09/2024]
Abstract
Foreign body aspirations and esophageal foreign bodies are lifethreatening conditions. Sometimes they or their complications can cause severe morbidity and even mortality. Their exact incidence is unknown. Foreign body aspirations and esophageal foreign bodies are most commonly observed in the pediatric age group. While interventions are generally required for the removal of respiratory tract foreign bodies, the majority of esophageal foreign bodies come out spontaneously. Removal of foreign bodies that block the lumen of the organ to a great extent, react with the mucosa such as battery magnets, and can cause poisoning, sharp-edged objects, and swellable foreign bodies such as legumes, should be done acutely. In the removal of foreign bodies, endoscopic methods (flexible/rigid bronchoscope) are used in the respiratory system. Other methods used in esophageal foreign bodies are follow-up and pushing and pulling maneuvers with equipment, and at times, open surgical procedures can be applied. The success of the procedures is high, and patients can be discharged in the early postoperative period. Their incidence can be decreased by raising awareness on the subject, parents can be prevented from making wrong applications in these cases, and clinicians can keep these conditions in mind in differential diagnosis. In this article, the clinical features and diagnosis and treatment methods of foreign body aspiration and esophageal foreign bodies will be discussed separately.
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Affiliation(s)
- Hüseyin Fatih Sezer
- Department of Thoracic Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Türkiye
| | - Aykut Eliçora
- Department of Thoracic Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Türkiye
| | - Salih Topçu
- Department of Thoracic Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Türkiye
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Langwinski A, Almeida AMD, Zilly A, Mayer PCM, Wysocki AD, Cicchelero LM, Ferreira H, Antonio Silva-Sobrinho R. Educational intervention about airway obstructions for early childhood teachers: a quasi-experimental study. Rev Gaucha Enferm 2023; 44:e20220335. [PMID: 37909516 DOI: 10.1590/1983-1447.2023.20220335.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 06/12/2023] [Indexed: 11/03/2023] Open
Abstract
OBJECTIVE To verify the effect of an educational intervention about airway obstructions and an airway clearing technique in teachers from Municipal Child Education Centers in a municipality in western Paraná. METHOD A quasi-experimental pre- and post-test study. Data was collectedusing a questionnaire with thirty questions to assess knowledge about the subject. For the analyses, the chi-square and McNemar tests were used, withanα = 5% of significance. RESULTS After the training sessions, there was a 16.22% increase in the number of correct answers to the questions dealing with the recognition of the obstruction (<0.0001) and the airway clearance technique (<0.0001). CONCLUSION The intervention improved the knowledge of early childhood teachers in the municipality regarding the identification of airway obstruction and techniquesairway clearing in school-age children.
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Affiliation(s)
- Adriano Langwinski
- Universidade Estadual do Oeste do Paraná (Unioeste). Foz do Iguaçu, Paraná, Brasil
| | | | - Adriana Zilly
- Universidade Estadual do Oeste do Paraná (Unioeste). Foz do Iguaçu, Paraná, Brasil
| | | | | | | | - Helder Ferreira
- Universidade Estadual do Oeste do Paraná (Unioeste). Foz do Iguaçu, Paraná, Brasil
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Saccomanno S, Saran S, Coceani Paskay L, De Luca M, Tricerri A, Mafucci Orlandini S, Greco F, Messina G. Risk factors and prevention of choking. Eur J Transl Myol 2023; 33:11471. [PMID: 37905785 PMCID: PMC10811631 DOI: 10.4081/ejtm.2023.11471] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/25/2023] [Indexed: 11/02/2023] Open
Abstract
Choking (or foreign body airway obstruction) is a widespread phenomenon with serious consequences of morbidity and mortality. Choking (often also called suffocation) can be caused by food or inedible objects and leads to various degrees of asphyxiation or lack of oxygen in the blood stream. The incidence is very high in both young children and adults, especially seniors. However, since not all choking episodes end up in the emergency room or become fatalities, they often escape statistics. Although episodes of choking from non-edible bodies are infrequent, they affect mostly young children. Three of the most common risks for choking in general are neurological disorders, dysphagia and dental issues (few or no teeth, unstable or unsuitable prosthesis or orthodontic appliances). The purpose of this study was to evaluate the risk factors of choking and ways to reduce/avoid this event. We reported data on a series of 138 patients admitted to the emergency department following a choking event, at a hospital in Rome, Italy. The age group of the analyzed population ranged from 1 to 88 years, with the most represented age group of these between 40 and 59, with a similar distribution between males and females. The types of foods on which people choked reflected the seasonal, traditional and local foods: 67% of patients reported choking on fish bones followed by meat bones (9%) and artichokes (3%). Three relevant non-food choking elements reported were: orthodontic items, toothpicks and pins (one occurrence each). We also reported on two clinical cases of patients choking on meat and a chicken bone. In conclusion, choking awareness and prevention are essential for implementing potential life-saving precautions. Prevention is the first tool to reduce the occurrence of this event, therefore it is necessary to analyze the risk factors and educate the population to eliminate them. Proper chewing and oral manipulation are paramount functions in preventing choking, along with meal-time supervision if little children and elderly. Then, it behooves the healthcare professionals to disseminate knowledge.
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Affiliation(s)
- Sabina Saccomanno
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila.
| | - Stefano Saran
- Department of Human Sciences, Innovation and Territory, School of Dentistry, University of Insubria, Varese.
| | | | - Martina De Luca
- Dental School, Catholic University of the Sacred Heart, Italy Rome.
| | | | | | - Francesca Greco
- Department of Radiology, New San Giovanni Battista Hospital, Foligno.
| | - Giuseppe Messina
- Department of Human Sciences and Promotion of the Quality of life of San Raffaele University Rome.
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Goulioumis AK, Peridis S, Koudmnakis E, Athanasopoulos I. A Foreign Body Lodged in the Glottis of a Toddler for a Prolonged Time: Anatomical Considerations and Review of the Literature. Cureus 2023; 15:e44489. [PMID: 37791175 PMCID: PMC10544457 DOI: 10.7759/cureus.44489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2023] [Indexed: 10/05/2023] Open
Abstract
Our scope is to present the unusual case of an impacted foreign body in a child's larynx for a prolonged period due to recurrent misdiagnosis and review the literature emphasizing the laryngeal foreign body. A toddler girl from a rural region was initially referred to a primary pediatric care center due to a sudden choking episode. The mother made an unsuccessful attempt to pull out a possible foreign body by blind finger sweeping. After 22 days of recurrent misdiagnosis and unsuccessful conservative therapies, the child developed hoarseness of voice and dyspnea during physical exertion. The patient underwent a flexible nasopharyngolaryngeal endoscopy, which observed a foreign body in the glottis, and an emergency microlaryngoscopy. Persistence of laryngeal symptoms in a child with a sudden choking episode should always raise the suspicion of a respiratory tract foreign body impaction. The most appropriate therapeutical approach is rigid bronchoscopy under general anesthesia.
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Affiliation(s)
| | | | | | - Ioannis Athanasopoulos
- Otolaryngology - Head and Neck Surgery, Pediatric Center of "Iatriko Athinon" Hospital, Athens, GRC
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9
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Karišik M. FOREIGN BODY ASPIRATION AND INGESTION IN CHILDREN. Acta Clin Croat 2023; 62:105-112. [PMID: 38746610 PMCID: PMC11090237 DOI: 10.20471/acc.2023.62.s1.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Abstract
Aspiration and ingestion of a foreign body is most frequently seen in children younger than 3 years. Foreign body aspiration is always a life-threatening, urgent state demanding quick recognition and treatment to avoid potentially lethal complications. Most foreign bodies that are ingested pass spontaneously through the gastrointestinal tract without complications, however, some could lead to problems if they become lodged. A literature review was performed via MEDLINE database using key terms. Primary care providers should be trained to give proper initial care. Aspirated/ingested foreign bodies in children removed by rigid or flexible bronchoscopy/gastroscopy always are challenging procedures that require well-planned anesthesia management and excellent intercommunication between anesthesiologists and surgeons. Extracorporeal membrane oxygenation can be used as a rescue mode of support in children with life-threatening foreign body aspiration for stabilization before, during and after removal of the aspirated foreign body. It is of utmost importance that all foreign body extractions, if possible, be done in centers supplied with all the necessary equipment and trained personnel. However, prevention of foreign body aspiration and ingestion is still the best therapy.
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Affiliation(s)
- Marijana Karišik
- Department of Anesthesiology and Intensive Care, Institute for Children Diseases, Clinical Center of Montenegro, Podgorica, Montenegro
- University of Montenegro, Faculty of Medicine, Podgorica, Montenegro
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10
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Bronchotomy for metal foreign object removal in pediatric airway. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2023. [DOI: 10.1016/j.epsc.2022.102549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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White JJ, Cambron JD, Gottlieb M, Long B. Evaluation and Management of Airway Foreign Bodies in the Emergency Department Setting. J Emerg Med 2023; 64:145-155. [PMID: 36806432 DOI: 10.1016/j.jemermed.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 11/03/2022] [Accepted: 12/13/2022] [Indexed: 02/19/2023]
Abstract
BACKGROUND Airway foreign body can be a life-threatening issue in pediatric and adult patients, and the majority of these patients will first present to the emergency department. OBJECTIVE This article provides a narrative review of the diagnosis and management of airway foreign bodies for the emergency clinician. DISCUSSION Foreign bodies in the upper and lower airways are potentially life threatening. This affects all age groups but is more common in pediatric patients. A history of a witnessed ingestion or aspiration event should raise the clinical suspicion for an aspirated foreign body. Patients with upper-airway foreign bodies are more likely to present in respiratory distress when compared with lower-airway foreign bodies, which often present with more subtle signs. Stridor, drooling, and wheezing suggest respiratory distress, but the presenting clinical picture is often unclear and may only include a cough. Immediate intervention is required in the patient with hemodynamic instability or respiratory distress. Airway management including laryngoscopy, fiberoptic bronchoscopy, and cricothyrotomy may be needed in these patients, with the emphasis on removing the obstructing foreign body and securing the airway. Specialist consultation can assist in retrieving the foreign body and managing the airway. If the patient is stable, imaging and specialist consultation for potential operating room intervention should be considered. CONCLUSIONS An understanding of the presentation, evaluation, and management of the patient with an airway foreign body is essential for emergency clinicians.
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Affiliation(s)
- Joshua J White
- Department of Emergency Medicine, Christus Spohn Shoreline, Corpus Christi, Texas
| | - John D Cambron
- Department of Emergency Medicine, Christus Spohn Shoreline, Corpus Christi, Texas
| | - Michael Gottlieb
- Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois
| | - Brit Long
- Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas
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12
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Shao H, Li S, He J, Wu L, Chen Z. A combination of flexible and rigid bronchoscopy in the successful removal of a residual fish bone from a peripheral bronchus: A case report. Front Pediatr 2023; 11:1114043. [PMID: 36896398 PMCID: PMC9989009 DOI: 10.3389/fped.2023.1114043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 02/06/2023] [Indexed: 02/23/2023] Open
Abstract
Although rigid bronchoscopy remains the gold standard for the management of foreign body (FB) inhalation, sometimes it still misses residual FBs. Inhalation of sharp FBs by infants is an uncommon but hazardous occurrence, which presents a significant challenge and demands expertise in therapeutic bronchoscopy. Particularly, residual sharp FBs in the peripheral tracheobronchial tree may pose challenging management problems for bronchoscopists. Herein, we describe the case of 1-year-old girl, who presented with persistent atelectasis in the left lower lobe for 20 days without responding to antibiotic therapy after removal of fish bone by rigid bronchoscopy at local hospital. Flexible bronchoscopy at our department showed a residual fish bone in the outer basal segment of the left lower lobe. A combined flexible and rigid bronchoscopy was then applied, and a fish bone measuring 1.5 cm in length was extracted on multiple attempts without any complications. Thus, our reports demonstrated that removal of challenging residual sharp FBs in the distal airways is possible with the aid of combined flexible and rigid bronchoscopy by an experienced multidisciplinary team. Additionally, a physician should pay special attention to abnormal chest images after removal of FBs.
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Affiliation(s)
- Hanqing Shao
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Shuxian Li
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.,Department of Endoscopy Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jing He
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Lei Wu
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.,Department of Endoscopy Center, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Zhimin Chen
- Department of Pulmonology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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13
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Nuts and Beans Aspiration in Children-Positive Respiratory Virus Does Not Rule Out Foreign Body Aspiration. Pediatr Emerg Care 2022; 38:e1698-e1699. [PMID: 35802486 DOI: 10.1097/pec.0000000000002803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Caffarelli C, Santamaria F, Piro E, Basilicata S, Delle Cave V, Cipullo M, Bernasconi S, Corsello G. New insights in pediatrics in 2021: choices in allergy and immunology, critical care, endocrinology, gastroenterology, genetics, haematology, infectious diseases, neonatology, neurology, nutrition, palliative care, respiratory tract illnesses and telemedicine. Ital J Pediatr 2022; 48:189. [PMID: 36435791 PMCID: PMC9701393 DOI: 10.1186/s13052-022-01374-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/25/2022] [Indexed: 11/28/2022] Open
Abstract
In this review, we report the developments across pediatric subspecialties that have been published in the Italian Journal of Pediatrics in 2021. We highlight advances in allergy and immunology, critical care, endocrinology, gastroenterology, genetics, hematology, infectious diseases, neonatology, neurology, nutrition, palliative care, respiratory tract illnesses and telemedicine.
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Affiliation(s)
- Carlo Caffarelli
- Department of Medicine and Surgery, Clinica Pediatrica, Azienda Ospedaliera-Universitaria, University of Parma, Via Gramsci 14, Parma, Italy.
| | - Francesca Santamaria
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Ettore Piro
- Department of Sciences for Health Promotion and Mother and Child Care G. D'Alessandro, University of Palermo, Palermo, Italy
| | - Simona Basilicata
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Valeria Delle Cave
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Marilena Cipullo
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | | | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care G. D'Alessandro, University of Palermo, Palermo, Italy
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Bandini A, Gandhi P, Sutton D, Steele CM. Bolus Texture Testing as a Clinical Method for Evaluating Food Oral Processing and Choking Risk: A Pilot Study. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2806-2816. [PMID: 36251878 PMCID: PMC9911109 DOI: 10.1044/2022_ajslp-22-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/04/2022] [Accepted: 06/21/2022] [Indexed: 05/03/2023]
Abstract
PURPOSE Choking on food is a leading cause of accidental death in several populations, including children, people with intellectual/developmental disability, and older adults in residential care facilities. One contributor to choking risk is incomplete oral processing and failure to convert food to a cohesive, nonsticky bolus with a maximum particle size that will not block the airway. Clinical tests of mastication do not evaluate properties of chewed food boluses. We characterized expectorated boluses, after oral processing, using methods developed by the International Dysphagia Diet Standardisation Initiative (IDDSI). METHOD Seventeen adults without dysphagia (seven women and 10 men), aged 23-55 years, chewed samples of a cracker, a raw baby carrot, and a circular, dome-shaped gummy candy. Chewing metrics were obtained up to the point when the person indicated that they were ready to swallow. The bolus was then either expectorated or swallowed; IDDSI tests were used to characterize the expectorated boluses. RESULTS Measures of chewing did not differ between spit and swallow conditions. Expectorated cracker and carrot boluses had maximum particle size consistent with IDDSI Level SB6 Soft & Bite-Sized foods or lower. The gummy candy samples remained at IDDSI Level RG7 Regular food consistency. CONCLUSIONS This study suggests that expectorated ready-to-swallow boluses are representative of boluses that are swallowed and that oral processing in adults without dysphagia typically results in boluses at IDDSI's Level SB6 or lower. IDDSI's testing methods provide a practical method for evaluating oral processing by characterizing expectorated ready-to-swallow boluses and may guide food texture recommendations for persons who have increased risk of choking.
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Affiliation(s)
- Andrea Bandini
- Swallowing Rehabilitation Research Laboratory, KITE Research Institute – Toronto Rehabilitation Institute, University Health Network, Ontario, Canada
- The BioRobotics Institute, Suola Superiore Sant'Anna, Pisa, Italy
- Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Pooja Gandhi
- Swallowing Rehabilitation Research Laboratory, KITE Research Institute – Toronto Rehabilitation Institute, University Health Network, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Danielle Sutton
- Swallowing Rehabilitation Research Laboratory, KITE Research Institute – Toronto Rehabilitation Institute, University Health Network, Ontario, Canada
| | - Catriona M. Steele
- Swallowing Rehabilitation Research Laboratory, KITE Research Institute – Toronto Rehabilitation Institute, University Health Network, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
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16
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Zhang SJ, Gu HB, Zhou M, Lin MY, Zhang LX, Chen XY, Lu GL. Risk factors associated with reintubations in children undergoing foreign body removal using flexible bronchoscopy: a single-center retrospective cross-sectional study. BMC Anesthesiol 2022; 22:219. [PMID: 35831787 PMCID: PMC9277839 DOI: 10.1186/s12871-022-01756-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/01/2022] [Indexed: 11/27/2022] Open
Abstract
Background Reintubation is a severe complication during foreign body (FB) removal that uses flexible bronchoscopy. Objective To investigate the incidence and risk factors for reintubations in children undergoing FB extraction by flexible bronchoscopy in a single center. Design A retrospective cross-sectional study. Setting All children with foreign body aspiration at Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University from January 2015 to December 2020. Patients Children with FB removal using a flexible bronchoscopy were enrolled in the trial according to the inclusion criteria. Measurements Both multivariable and logistic regression analyses were used to analyze the association between characteristic data and reintubations. The results were presented as odds ratios (ORs) with 95% confidence intervals (CIs). Results In total, 244 patients met with the inclusion criteria and were included in the analysis. Among those participants, 28 children (11.5%) underwent reintubations after FB removal by flexible bronchoscopy. Independent factors associated with reintubations were identified as operative time ≥ 60 min [OR: 3.68, 95% CI (1.64–8.82)] and ASA ≥ III [OR: 5.7, 95% CI (1.23–26.4)]. Conclusions Children undergoing FB removal by a flexible bronchoscopy may encounter with a high incidence of postoperative reintubations. Both long operative duration and a severe physical status cause a growing risk of reintubations.
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Affiliation(s)
- Su-Jing Zhang
- Department of Anesthesiology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.,Department of Anesthesiology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Branch of Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Fujian Children's Hospital, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fuzhou, China
| | - Hong-Bin Gu
- Department of Anesthesiology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Branch of Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Fujian Children's Hospital, Fuzhou, China.,Department of anesthesia, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Shanghai, China
| | - Min Zhou
- Department of Anesthesiology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.,Department of Anesthesiology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Branch of Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Fujian Children's Hospital, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fuzhou, China
| | - Min-Yi Lin
- Department of Anesthesiology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Branch of Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Fujian Children's Hospital, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fuzhou, China
| | - Long-Xin Zhang
- Department of Anesthesiology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fuzhou, China
| | - Xiu-Ying Chen
- Department of Anesthesiology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fuzhou, China
| | - Guo-Lin Lu
- Department of Anesthesiology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China. .,Department of Anesthesiology, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fujian Branch of Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Fujian Children's Hospital, Fuzhou, China. .,Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fuzhou, China.
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17
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Successful Management Foreign Body Aspiration Associated with Severe Respiratory Distress and Subcutaneous Emphysema: Case Report and Literature Review. Medicina (B Aires) 2022; 58:medicina58030396. [PMID: 35334572 PMCID: PMC8955108 DOI: 10.3390/medicina58030396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 11/17/2022] Open
Abstract
The presence of a foreign body in the airway is a potentially life-threatening clinical condition that requires urgent medical attention. We present a case of a 12-year-old boy who presented in the emergency room with a history of an episode of choking after aspiration of a foreign body, followed by severe respiratory distress and subcutaneous emphysema. Chest radiography revealed hyperinflation data, pneumothorax, and subcutaneous emphysema data. The flexible bronchoscope examination showed the presence of an inorganic foreign body impacted on the carina with tracheal lesions and laryngeal edema. It was necessary to perform a tracheostomy for its definitive extraction. The gold standard in the treatment of foreign body aspiration is bronchoscopy; although, in children, the technique adopted continues to be controversial, flexible bronchoscopy can be effective and very useful.
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Clinical Risk Management: As Modern Tool for Prevention and Management of Care and Prevention Occupational Risk. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020831. [PMID: 35055652 PMCID: PMC8776016 DOI: 10.3390/ijerph19020831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 02/05/2023]
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19
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Kosutova P, Mikolka P. Aspiration syndromes and associated lung injury: incidence, pathophysiology and management. Physiol Res 2021. [DOI: 10.33549//physiolres.934767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Aspiration is a common condition affecting healthy or sick patients which could create an acute or chronic inflammatory reaction in the lungs. Aspiration syndromes could be categorized according to a content entering the respiratory system into bacterial aspiration pneumonia with the gastric or oropharyngeal bacteria entering, aspiration chemical pneumonitis with bacteria-freegastric acid aspiration, or aspiration of a foreign body which causes an acute pulmonary emergency. There are differences in the clinical presentation of volume-dependent aspirations (microaspiration and macroaspiration): the higher is the volume of aspiration, the greater is the injury to the patient and more serious are the health consequences (with 70 % mortality rate for hospitalized patients). Aspiration syndromes can affect both the airways and pulmonary parenchyma, leading to acute lung injury, increased hospitalization rate and worse outcomes in critically ill patients. Impaired alveolar-capillary permeability, oedema formation, neutrophilic inflammatory response and pulmonary surfactant inactivation lead to reduced lung compliance and loss of aerated lung tissue and give rise to hypoxemia and respiratory failure. This review discusses the effect of aspiration events on the pulmonary tissue. The main focus is to distinguish the differences between bacterial and chemical pneumonia, their clinical presentation and symptoms, risk factors of developing the changes, possibilities of diagnostics and management as well as prevention of aspirations. Because of a risk of serious lung damage after the aspiration, pathophysiology and processes leading to lung tissue injury are discussed in detail. Data sources represent a systematic literature search using relevant medical subject headings.
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A new scoring system and clinical algorithm for the management of suspected foreign body aspiration in children: a retrospective cohort study. Ital J Pediatr 2021; 47:194. [PMID: 34583774 PMCID: PMC8480080 DOI: 10.1186/s13052-021-01147-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cases of foreign body aspiration in children may be encountered in emergency departments. A suggestive history is important in diagnosing aspirated foreign body owing to the difficulty in making a diagnosis on the basis of an abnormal physical examination or chest radiography alone. The aim of this study was to examine the sensitivity and specificity of the presenting symptoms, physical examination, and radiologic findings as predictors of foreign body aspiration in children. In addition, a feasible simple algorithm with a scoring system was generated to indicate bronchoscopic investigation. METHODS In a retrospective cohort, medical records of patients aged less than 16 years with suspected foreign body aspiration who underwent flexible or rigid bronchoscopy were included. Data including age, sex, symptoms, physical examination findings, radiological features, nature and location of the foreign body, and outcome of the bronchoscopy were collected, and multivariable binary logistic regression analysis was employed for prediction of foreign body aspiration. RESULTS A total of 203 children were included, and the model showed excellent discrimination power for positive foreign body aspiration (area under the curve = 0.911) with an accuracy, sensitivity, and specificity of 86.2, 90.6, and 76.6%, respectively. The total weighted risk score at a cut-off > 2 showed a significant good power of discrimination (area under the curve = 0.879), with a sensitivity of 79.9% and specificity of 84.4%. Accordingly, a clinical algorithm was recommended. CONCLUSIONS The proposed scoring system and clinical algorithm might help in decision making with regard to the need and type of bronchoscopy in children presenting with potential foreign body aspiration. However, further prospective multicenter studies should be conducted to validate this scoring system.
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Hochdorn A, Oliveira A, Lorenzoni G, Francavilla A, Baldas S, Berchialla P, Oliveira A, Alves VP, Gregori D, Azzolina D. Monitoring Public Perception of Health Risks in Brazil and Italy: Cross-Cultural Research on the Risk Perception of Choking in Children. CHILDREN (BASEL, SWITZERLAND) 2021; 8:541. [PMID: 34202693 PMCID: PMC8307887 DOI: 10.3390/children8070541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/20/2021] [Accepted: 06/22/2021] [Indexed: 11/17/2022]
Abstract
One of the most relevant public health issues among pediatric injuries concerns foreign body (FB) aspiration. The risk perception of choking hazards (CH) and risk perception, in general, are complex multifactorial problems that play a significant role in defining protective behavior. Risk prevention policies should take this aspect into account. A lack of scientific knowledge of FB injury risk perception may be evidenced in Brazil and other newly developed countries. This study aims to characterize the differences and peculiarities in risk perception of CH between Italian and Brazilian populations. The risk perception among adults in Italy and Brazil between September and October 2017 was investigated in a survey. A Multiple Correspondence Analysis was carried out to identify the latent components characterizing the risk perception in Italian and Brazilian population samples. The most relevant dimension characterizing risk perception is the "Professional-educational status and the related perception of Risk" (13% of factorial inertia). The Italians identify batteries and magnets as the most dangerous choking risks (20% of responses). On the other hand, Brazilian people, mainly manual laborers (22%) with secondary or primary education (94%), perceive coins as the most dangerous items (30% of responses, p < 0.001). Socio-economic issues characterize the subjective risk perception of Italian and Brazilian survey respondents. In this framework, data-driven prevention strategies could be helpful to tailor intervention strategies to the cultural context to which they are addressed.
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Affiliation(s)
- Alexander Hochdorn
- Department of Social and Work Psychology, University of Brasília, Brasília 72220-275, Brazil;
| | - Alexia Oliveira
- School of Medicine and Healthcare Sciences, Catholic University of Brasília, Brasília 72220-275, Brazil; (A.O.); (A.O.); (V.P.A.)
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy; (G.L.); (A.F.); (D.A.)
| | - Andrea Francavilla
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy; (G.L.); (A.F.); (D.A.)
| | | | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Torino, 10124 Torino, Italy;
| | - Alessandra Oliveira
- School of Medicine and Healthcare Sciences, Catholic University of Brasília, Brasília 72220-275, Brazil; (A.O.); (A.O.); (V.P.A.)
| | - Vicente Paulo Alves
- School of Medicine and Healthcare Sciences, Catholic University of Brasília, Brasília 72220-275, Brazil; (A.O.); (A.O.); (V.P.A.)
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy; (G.L.); (A.F.); (D.A.)
| | - Danila Azzolina
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy; (G.L.); (A.F.); (D.A.)
- Department of Medical Science, University of Ferrara, 44121 Ferrara, Italy
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22
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Almutairi AT, Alharbi FS. Parental knowledge and practices toward foreign body aspiration in children in the Al Qassim region of Saudi Arabia. J Family Med Prim Care 2021; 10:199-204. [PMID: 34017726 PMCID: PMC8132851 DOI: 10.4103/jfmpc.jfmpc_1500_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/17/2020] [Accepted: 10/28/2020] [Indexed: 11/04/2022] Open
Abstract
Background: Foreign body aspiration (FBA) is a perilous condition with a high mortality rate, especially in children less than three years of age. Aim: This study aimed to assess parental knowledge and practices toward FBA in children in the Al Qassim region of Saudi Arabia. Materials and Methods: This is a descriptive cross-sectional study conducted among Saudi parents at AlQassim region, Saudi Arabia during the period between February 2020 and June 2020. A validated self-administered questionnaire containing 16 questions of knowledge and practices toward FBA was distributed online via various Social Media platforms. Correct answers were coded and scored. Participant responses were grouped based on their score level of knowledge and practices. Results: We recruited 385 parents with a mean age of 35.4 (range: 19–59) years, and 59.2% were female and 40.8% were male. The mean ± SD knowledge score was 4.97 (1.42)/8 points and the practice score was 12.4 (2.13)/20 points. Parents with poor and good knowledge were 61.3% and 36.9% and those with poor and good practices were 55.3% and 44.7%, respectively. Female professionals with less children who were more aware of FBA significantly influenced knowledge, while having no incidence of FBA among children and having heard of FBA significantly influenced practices. Conclusion: We found that parental knowledge and practices toward FBA were insufficient. Educated females with less children that heard about FBA influenced parental knowledge. Also, having no incidence of FBA among children and being aware about FBA led to a better impact in parental practices.
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Affiliation(s)
- Aisha T Almutairi
- Department of Pediatrics, College of Medicine, Qassim University, Buridah, Saudi Arabia
| | - Fahad S Alharbi
- Medical intern, College of Medicine, Qassim University, Buridah, Saudi Arabia
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Esposito M, Montana A, Liberto A, Filetti V, Nunno ND, Amico F, Salerno M, Loreto C, Sessa F. Anaphylactic Death: A New Forensic Workflow for Diagnosis. Healthcare (Basel) 2021; 9:healthcare9020117. [PMID: 33499408 PMCID: PMC7911323 DOI: 10.3390/healthcare9020117] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/11/2021] [Accepted: 01/20/2021] [Indexed: 01/26/2023] Open
Abstract
Anaphylaxis is a life-threatening or fatal clinical emergency characterized by rapid onset, and death may be sudden. The margin of certainty about the diagnosis of anaphylactic death is not well established. The application of immunohistochemical techniques combined with the evaluation of blood tryptase concentrations opened up a new field of investigation into anaphylactic death. The present study investigated eleven autopsy cases of anaphylactic death, carried out between 2005 and 2017, by the Departments of Forensic Pathology of the Universities of Foggia and Catania (Italy). An analysis of the medical records was carried out in all autopsies. Seven autopsies were carried out on males and four on females. Of the eleven cases, one showed a history of asthma, one of food ingestion, two of oral administration of medications, six did not refer any allergy history, and one subject was unknown. All cases (100%) showed pulmonary congestion and edema; 7/11 (64%) of the cases had pharyngeal/laryngeal edema and mucus plugging in the airway; only one case (9%) had a skin reaction that was found during external examination. Serum tryptase concentration was measured in ten cases, and the mean value was 133.5 µg/L ± 177.9. The immunohistochemical examination using an anti-tryptase antibody on samples from the lungs, pharynx/larynx, and skin site of medication injection showed that all cases (100%) were strongly immunopositive for anti-tryptase antibody staining on lung samples; three cases (30%) were strongly immunopositive for anti-tryptase antibody staining on pharyngeal/laryngeal samples; and eight cases (80%) were strongly immunopositive for anti-tryptase antibody staining on skin samples. We conclude that a typical clinical history, blood tryptase level >40 µg/L, and strongly positive anti-tryptase antibody staining in the immunohistochemical investigation may represent reliable parameters in the determination of anaphylactic death with the accuracy needed for forensic purposes.
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Affiliation(s)
- Massimiliano Esposito
- Legal Medicine, Department of Medical, Surgical and Advanced Technologies, “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy; (M.E.); (A.M.); (A.L.); (F.A.)
| | - Angelo Montana
- Legal Medicine, Department of Medical, Surgical and Advanced Technologies, “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy; (M.E.); (A.M.); (A.L.); (F.A.)
| | - Aldo Liberto
- Legal Medicine, Department of Medical, Surgical and Advanced Technologies, “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy; (M.E.); (A.M.); (A.L.); (F.A.)
| | - Veronica Filetti
- Human Anatomy and Histology, Department of Biomedical and Biotechnology Sciences, University of Catania, 95123 Catania, Italy; (V.F.); (C.L.)
| | - Nunzio Di Nunno
- Department of History, Society and Studies on Humanity, University of Salento, 73100 Lecce, Italy;
| | - Francesco Amico
- Legal Medicine, Department of Medical, Surgical and Advanced Technologies, “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy; (M.E.); (A.M.); (A.L.); (F.A.)
| | - Monica Salerno
- Legal Medicine, Department of Medical, Surgical and Advanced Technologies, “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy; (M.E.); (A.M.); (A.L.); (F.A.)
- Correspondence: ; Tel.: +39-3735357201
| | - Carla Loreto
- Human Anatomy and Histology, Department of Biomedical and Biotechnology Sciences, University of Catania, 95123 Catania, Italy; (V.F.); (C.L.)
| | - Francesco Sessa
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
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