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因摄入聚丙烯酸钠导致气道阻塞:一例报告

Airway obstruction due to ingestion of sodium polyacrylate: a case report.

作者信息

Stalder Andreas, Guechi Youcef, Bonnemain Claire-Lise, Schmutz Thomas

机构信息

Emergency Department, Fribourg Hospital, 2-6 Chemin des Pensionnats, Fribourg, 1708, Switzerland.

University of Fribourg, Fribourg, Switzerland.

出版信息

Int J Emerg Med. 2024 Oct 4;17(1):137. doi: 10.1186/s12245-024-00730-1.

Abstract

BACKGROUND

Super-absorbent polymers (SAPs) possess the ability to absorb large amounts of water and are widely used in medical settings. Commonly used in vomit bags to contain fluids, reduce spillage, and enhance bedside hygiene, SAPs are generally regarded as safe and non-toxic. However, we report a tragic incident where the accidental ingestion of SAPs led to fatal asphyxiation, highlighting a critical safety concern.

CASE PRESENTATION

A 76-year-old female suffering from advanced Alzheimer's dementia was brought to the emergency department following a fall with cervical trauma. Following a complaint of nausea, she was given a vomit bag containing a sachet of approximately 9 g of SAP. Thirty minutes later, she was found deceased in the waiting area, with a grayish, half-hardened gel blocking her oropharynx and remnants of a chewed SAP sachet. Pathological analysis confirmed death by asphyxiation caused by the SAP expanding in her oropharynx upon contact with saliva.

CONCLUSIONS

This case emphasizes the potential dangers of SAPs when accidentally ingested and it is imperative that such products are kept out of reach of vulnerable populations. In cases of airway obstruction, there are no specific treatments available. Laryngoscopy may be impossible, necessitating the prompt consideration of an emergency tracheotomy. Experimental data suggest the use of an aerosol of warm alkaline hydrogen peroxide solution to dissolve these obstructive foreign bodies, but further studies are needed to validate its use in emergency situations.

摘要

背景

高吸水性聚合物(SAPs)具有吸收大量水分的能力,在医疗环境中被广泛使用。SAPs通常用于呕吐袋中以容纳液体、减少溢出并提高床边卫生水平,一般被认为是安全无毒的。然而,我们报告了一起悲剧事件,意外摄入SAPs导致致命窒息,凸显了一个关键的安全问题。

病例介绍

一名76岁患有晚期阿尔茨海默病痴呆症的女性因跌倒致颈椎创伤被送往急诊科。在主诉恶心后,她被给予一个装有约9克SAP小袋的呕吐袋。30分钟后,她被发现死于等候区,灰白色、半硬化的凝胶阻塞了她的口咽,还有一个被咬过的SAP小袋的残余物。病理分析证实死因是SAP与唾液接触后在她的口咽中膨胀导致窒息。

结论

该病例强调了意外摄入SAPs的潜在危险,此类产品必须放在弱势群体够不到的地方。在气道阻塞的情况下,没有可用的特效治疗方法。喉镜检查可能无法进行,需要迅速考虑紧急气管切开术。实验数据表明,使用温热的碱性过氧化氢溶液气雾剂来溶解这些阻塞性异物,但需要进一步研究以验证其在紧急情况下的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f681/11451021/2b126bd17109/12245_2024_730_Fig1_HTML.jpg

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