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Choking
- 1. CHOKING
- 3. CHOKING RESPIRATORY OBSTRUCTION BY Col Anwar ul Haq Classified ENT Specialist
- 5. SITES OF OBSTRUCTION NOSE NASOPHARYNX OROPHARYNX LARYNX TRACHEA
- 6. OBSTRUCTION-NOSE • NOSE – BYPASSED NOSE NASOPHARYNX • BREATHE – ORAL CAVITY
- 7. CHOKING • UNCONSCIOUS – JAW FALLS BACK – AIRWAY OBSTRUCTION OBS. AIRWAY • JAW THURST – AIRWAY IS MAINTAINED OPEN AIRWAY
- 8. CHOKING • TRAUMA – MECHANICAL • MANDIBLE • TONGUE • NECK – – penetrating – strangulation – CHEMICAL – THERMAL – RADIOTHERAPY • FOREIGN BODIES • INFECTIONS
- 9. TRAUMA • MECHANICAL – MANDIBLE – TONGUE – NECK – • PENETRATING • STRANGULATION
- 10. TRAUMA • MECHANICAL – MANDIBLE – TONGUE – NECK – • PENETRATING • STRANGULATION
- 11. TRAUMA • MECHANICAL – MANDIBLE – TONGUE – NECK – • PENETRATING • STRANGULATION
- 12. TRAUMA • MECHANICAL – MANDIBLE – TONGUE – NECK – • PENETRATING • STRANGULATION
- 13. TRAUMA ORAL CAVITY & TONGUE • BLOOD • CONSCIOUS – SIT UP • SECRETIONS – LEAN FORWARD • TONGUE - FALL BACK – SPIT • UNCONSCIOUS / CHILD – LATERAL – MOUTH • LOWER – SUCTION CLEARANCE • CRICOTHYROIDOTOMY • TRACHEOSTOMY
- 14. TRAUMA NECK • LARYNX & TRACHEA HYOID – FRACTURES – HAEMATOMA THYROID – BLOOD – SECRETIONS CRICOID
- 15. TRAUMA NECK • SUCTION CLEARANCE • ENDOTRACHEAL TUBE • CRICOTHYROIDOTOMY • TRACHEOSTOMY
- 16. CRICOTHYROIDOTOMY MAKING A HOLE IN CRICOTHYROID MEMBRANE
- 21. TRAUMA • CHEMICAL • DELAYED • THERMAL • OBSERVATION • RADIOTHERAPY • OXYGEN • ET INTUBATION
- 22. TRAUMA • CHEMICAL • DELAYED • THERMAL • OBSERVATION • RADIOTHERAPY • OXYGEN • ET INTUBATION • TRACHEOSTOMY
- 23. TRACHEOSTOMY
- 24. TRACHEOSTOMY CREASE INCISION
- 25. STRAP MUSCLES DISSECTED THYROID ISTHMUS RETRACTED
- 27. CUFFED UNCUFFED DOUBLE LUMEN METALLIC
- 29. AIR
- 30. FOREIGN BODIES • CHILDREN • AGE < 5 YRS (84%) • M:F :: 2:1 • NATURE - VEGETABLE (55 – 95%) - NUTS - METAL (5 – 15%) - PLASTIC (5 – 15%)
- 31. SITE OF OBSTRUCTION • NOSE – BYPASSED • BREATHE – ORAL CAVITY • NEONATES – OBLIGATORY NASAL BREATHERS
- 32. SITE OF OBSTRUCTION (PHARYNX) • BLUNT/SMALL - DO NOT STAY » SWALLOWED • SHARP – TONSIL, BASE OF TONGUE, VALLECULAE, PYRIFORM FOSSAE – MORE DISCOMFORT – LESS OBSTRUCTION • VERY BIG- CHILDREN » DO NOT GAG MUCH » CANNOT TAKE OUT – SEVERE RESPIRATORY OBSTRUCTION
- 33. RIGHT MAIN BRONCHU S WIDE STRAIGHT
- 34. SITE OF OBSTRUCTION (LARYNX & TRACHEA) COMPLETE OBSTRUCTION – FATAL OUTCOME – IF DISLODGEMENT FAILS
- 35. SITE OF OBSTRUCTION (LARYNX & TRACHEA) COMPLETE OBSTRUCTION – FATAL OUTCOME – IF DISLODGEMENT FAILS • INCOMPLETE OBST. – HOARSENESS – APHONIA – COUGH – DYSPNOEA
- 36. FART WHISTLE MUSICAL CHILD
- 37. STAGES OF PRESENTATION • INITIAL PERIOD - EMERGENCY – CHOKING – GAGGING – WHEEZING • SYMPTOMLESS INTERVAL–VARIABLE • DURATION • NATURE OF FORGEIN BODY • 20-50% NOT DETECTED WITHIN FIRST WEEK • LATE SYMPTOMS - COMPLICATIONS • OBSTRUCTION • INFLAMMATION • TRAUMA
- 38. CHOKING WITNESSED COMPLETE OBSTRUCTION • HEIMLICH’S MANOEUVRE • BACK BLOW • CHEST THRUST • ABDOMINAL THRUST • AIM – USE THE AIR IN LUNGS – TOOL TO DISLODGE THE F.B.
- 39. HEIMLICH’S MANOEUVRE USE THE AIR IN LUNGS TOOL TO DISLODGE THE F.B.
- 40. USE THE AIR IN LUNGS TOOL TO DISLODGE THE F.B.
- 41. CHOKING WITNESSED COMPLETE OBSTRUCTION • HEIMLICH’S MANOEUVRE • BACK BLOW • CHEST THRUST • ABDOMINAL THRUST
- 42. CHOKING WITNESSED COMPLETE OBSTRUCTION CHEST THRUST BELOW CHEST THORACIC SPINE • HEIMLICH’S MANOEUVRE • BACK BLOW • CHEST THRUST • ABDOMINAL THRUST
- 43. CHOKING WITNESSED COMPLETE OBSTRUCTION • HEIMLICH’S MANOEUVRE • BACK BLOW • CHEST THRUST • ABDOMINAL THRUST ABDOMINAL THRUST ABDOMEN LUMBER SPINE
- 46. CHILDREN - CHOKING WITNESSED COMPLETE OBSTRUCTION • IF ALL FAIL – BACK BLOW – CHEST THRUST – ABDOMINAL THRUST • AIRWAY NOT ESTB. – CRICOTHYROIDOTOMY – TRACHEOSTOMY
- 47. CHILDREN - CHOKING WITNESSED COMPLETE OBSTRUCTION • IF ALL FAIL – BACK BLOW – CHEST THRUST – ABDOMINAL THRUST • AIRWAY NOT ESTB. – CRICOTHYROIDOTOMY – TRACHEOSTOMY • AIRWAY ESTB.(HOSPITAL) – LARYNGOSCOPY – TRACHEOSCOPY – BRONCHOSCOPY
- 48. CHILDREN - CHOKING UNWITNESSED COMPLETE OBSTRUCTION DEATH
- 49. CHILDREN - CHOKING WITNESSED ADULTS - HISTORY POSITIVE (INCOMPLETE OBSTRUCTION) • DO NOT ATTEMPT – REMOVE – PROBE – MANOEUVRE • OXYGEN • REMOVAL – LARYNGOSCOPE – TRACHEOSCOPE – BRONCHOSCOPE
- 52. FB IN ADULTS • HISTORY POSITIVE – NO SYMPTOMS AND SIGNS • INVESTIGATE • TREAT • NO HISTORY – SYMPTOMS AND SIGNS • INVESTIGATE • TREAT
- 53. INFECTIONS • LUDWIG’S ANGINA • AC. EPIGLOTTITIS • LARYNGOTRACHEOBRONCHITIS
- 54. LUDWIG’S ANGINA • SWELLING OF THE FLOOR OF MOUTH • TONGUE.... SUP AND POSTERIORLY • SITS - LEANING FORWARD • TRACHEOSTOMY.....
- 55. AC EPIGLOTTITIS • SWELLING OF THE EPIGLOTTIS • POSITION - LEANING FORWARD • THUMB SIGN • EXAM IN OT • ET TUBE... • TRACHEOSTOMY
- 56. LARYNGOTRACHEOBRONCHITIS • INFLAMATION OF AIRWAY • GRADUAL ONSET • STEEPLE SIGN • O2 INHALATION ....
- 57. LARYNGOTRACHEOBRONCHITIS • INFLAMATION OF AIRWAY • GRADUAL ONSET • STEEPLE SIGN • O2 INHALATION .... • ET TUBE
- 59. CONCLUSION • A - AIRWAY • B -BREATHING • C -CIRCULATION
- 60. CONCLUSION • A - AIRWAY • B - BREATHING • C - CIRCULATION • ABC IS TRUE SEQUENCE OF – BASIC – LIFE – SUPPORT
- 61. THANK YOU
- 62. CHOKING
- 63. SITUATION-1 MOTHER • ONE MONTH OLD BABY • SUDDENLY FOUND APOENIC • MOTHER CAME OUT OF WASHROOM
- 64. SITUATION-2 PATIENT+ATTENDANT+DOCTOR IN MRC • FOUR SOLDIERS PLAYING LUDDO – CMH UNIT LINES • ONE KEEPING GOAT IN MOUTH • SUDDENLY STARTED DYSPNOEA • BECAME RESTLESS • NOISY BREATHING