Foreign body aspiration
Summary
Definition
Foreign body aspiration is the inhalation of a foreign body into the larynx and respiratory tract.[1][Figure caption and citation for the preceding image starts]: Loquat seed completely occluding the bronchus intermediusFrom the collection of Dr Septimiu Murgu and Dr Henri Colt; used with permission [Citation ends].
History and exam
Key diagnostic factors
- presence of risk factors
- choking crisis
- unilateral decreased breath sounds
- unilateral wheezing
Other diagnostic factors
- intractable cough
- fever
- dyspnoea
- bilateral wheezing
Risk factors
- decreased level of consciousness (Glasgow coma score <9)
- age <4 years
- age >70 years
- bulbar dysfunction
- male sex
- cerebrovascular disease
- dementia
Diagnostic investigations
1st investigations to order
- chest x-ray
Investigations to consider
- CT chest
- bronchoscopy
Treatment algorithm
conscious
unconscious
Contributors
Authors
Arjun B. Chatterjee, MD, MS, FACP, FCCP, FAASM
Professor of Medicine
Section on Pulmonary, Critical Care, Allergy, and Immunologic Disease
Wake Forest University School of Medicine
Winston-Salem
NC
Disclosures
ABC declares that he has no competing interests. His opinions are his own and do not represent those of his employers: Wake Forest University School of Medicine; US Department of Defense - United States Navy; US Department of Veteran’s Affairs.
Acknowledgements
Dr Arjun B. Chatterjee would like to gratefully acknowledge Dr Septimiu Murgu and Dr Henri Colt, the previous contributors to this topic. SM and HC declare that they have no competing interests.
Peer reviewers
Amber Young, BSc, MB ChB, FRCA
Consultant Paediatric Anaesthetist
Department of Anaesthesia
Frenchay Hospital
Bristol
UK
Disclosures
AY declares that she has no competing interests.
Momen M. Wahidi, MD, MBA
Director
Interventional Pulmonology
Division of Pulmonary, Allergy, and Critical Care Medicine
Assistant Professor of Medicine
Duke University Medical Center
Durham
NC
Disclosures
MMW declares that he has no competing interests.
Pyng Lee, MD
Senior Consultant
Department of Respiratory and Critical Care Medicine
Singapore General Hospital
Singapore
Disclosures
PL declares that he has no competing interests.
Differentials
- Asthma exacerbation
- Cystic fibrosis with exacerbation
- Acute COPD exacerbation
More DifferentialsGuidelines
- European Resuscitation Council guidelines 2021: Executive summary
- Flexible airway endoscopy in children
More GuidelinesPatient leaflets
Pneumonia
Bronchoscopy
More Patient leaflets
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