Benson Don M
Emergency Medicine, Garden City Hospital, Michigan State University, Garden City, USA.
Cureus. 2024 Nov 29;16(11):e74785. doi: 10.7759/cureus.74785. eCollection 2024 Nov.
This case report describes a near-fatal airway obstruction in a woman attempting to conceal drug contraband in her mouth. A patient was brought to the emergency department by emergency medical services accompanied by police after she had refused to open her mouth after being detained. The patient was initially seen at triage, being awake and responsive, but still refusing to open her mouth. While in the emergency department, she rapidly deteriorated exhibiting signs of upper airway obstruction. The patient had aspirated a plastic bag presumably containing "crack" cocaine which completely occluded her trachea. Immediate intervention consisting of direct laryngoscopy and forceps removal of the foreign body was necessary to preserve life. The case is presented as a warning to law enforcement, emergency physicians, and other first responders that a patient who will not open their mouth while attempting to conceal narcotics is at risk for aspiration, airway obstruction, and death. Patients presenting to the emergency department with this history should be closely monitored in a high-acuity area with anticipation of the need for emergency intervention to achieve and maintain airway patency.
本病例报告描述了一名女性试图将毒品违禁品藏于口中时发生的近乎致命的气道阻塞情况。该患者被警方拘留后拒绝开口，随后被紧急医疗服务人员送往急诊科。患者最初在分诊处被检查时，神志清醒且有反应，但仍拒绝开口。在急诊科期间，她迅速病情恶化，出现上气道阻塞的迹象。患者吸入了一个可能装有“快克”可卡因的塑料袋，该塑料袋完全阻塞了她的气管。为挽救生命，必须立即进行直接喉镜检查并用镊子取出异物的干预措施。此病例旨在向执法人员、急诊医生和其他急救人员发出警示，即试图隐藏毒品时不愿开口的患者有发生误吸、气道阻塞和死亡的风险。有此病史前来急诊科就诊的患者应在高监护区域密切监测，同时预期可能需要紧急干预以确保并维持气道通畅。
