Senior Consultant Emergency Physician & ED Critical Care, Resuscitation & Emergency Critical Care Unit, Trauma & Emergency Department, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia.
Emergency Physician & ED Critical Care, Resuscitation & Emergency Critical Care Unit, Trauma & Emergency Department, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia; Trauma & Emergency Department, Tuanku Ja'afar Hospital, Seremban, Negeri Sembilan, Malaysia.
Am J Emerg Med. 2022 Mar;53:23-28. doi: 10.1016/j.ajem.2021.12.027. Epub 2021 Dec 17.
As foreign body airway obstruction (FBAO) can be life-threatening, it has to be promptly diagnosed and treated. We report a case series of three patients presenting to the emergency department with cardiac arrest due to FBAO. In each case, ventilation was difficult due to high airway resistance. As FBAO was suspected, the emergency physician did a prompt flexible bronchoscopy to confirm the diagnosis and retrieve the foreign body. Flexible bronchoscopy is an important diagnostic and therapeutic tool for emergency airway management, and is a relatively safe procedure if performed by a trained personnel. The life-saving benefits of bronchoscopy outweigh the small risks of complications such as bleeding, desaturation and pneumothorax. In the three cases, the removal of the obstructing material led to immediate improvements in oxygenation and ventilation. The patients had return of spontaneous circulation after cardiopulmonary resuscitation and definite airway control.
由于异物气道阻塞（FBAO）可能危及生命，因此必须迅速诊断和治疗。我们报告了三例因 FBAO 导致急诊科心脏骤停的患者病例系列。在每种情况下，由于气道阻力高，通气都很困难。由于怀疑 FBAO，急诊医生迅速进行了软性支气管镜检查以确认诊断并取出异物。软性支气管镜检查是紧急气道管理的重要诊断和治疗工具，如果由经过培训的人员进行，则是一种相对安全的程序。支气管镜检查的救生益处大于出血、低氧血症和气胸等并发症的小风险。在这三个案例中，阻塞物的清除导致氧合和通气立即改善。在心肺复苏后，患者的自主循环恢复，气道得到明确控制。
