Intrabronchial tablets—Jet propelled A case report

Wiesel, Jochannan M.; Bar, Z.G.; Feinmesser, Raphael

doi:10.1017/s0022215100090629

Cited by 12 publications

(8 citation statements)

References 3 publications

(2 reference statements)

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“…There have been similar aspiration case reports. 7,8 Therefore, it is very important for the patient to check the inhaler for foreign bodies before using the inhaler, and to cap the inhaler after use. Design mod-ification of inhalers could help decrease the risk of foreign-body aspiration.…”

Section: Discussionmentioning

confidence: 99%

Aspiration of a Cigarette Filter From a Bronchodilator Inhaler

Eliçora

Liman²,

Aşlı³

et al. 2013

Respir Care

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The majority of foreign-body aspirations are seen in children. In adults, neurological dysfunction, trauma, alcohol abuse, or psychological disorders can lead to aspiration, but normal adults can also suffer foreign body aspiration. The symptoms include acute asphyxiation, with or without complete airway obstruction, cough, dyspnea, choking, and fever, which also occur in many other medical conditions. Bronchoscopic removal of the foreign body is necessary, and flexible bronchoscopy is effective in the diagnosis and removal. We saw a patient with COPD who aspirated a plastic cigarette filter while using his bronchodilator inhaler.

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Section: Discussionmentioning

confidence: 99%

Aspiration of a Cigarette Filter From a Bronchodilator Inhaler

Eliçora

Liman²,

Aşlı³

et al. 2013

Respir Care

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“…[5][6][7][8][9][10][11][12] In all these reports the objects aspirated were found in the mainstem bronchi during endoscopy. [5][6][7][8][9][10][11][12] Additionally, laryngeal aspiration has also been suspected after inhaler use, resulting in a choking episode followed by expectoration of an MDI cap. Indirect laryngoscopy revealed left vocal cord edema.…”

Section: Discussionmentioning

confidence: 99%

“…Loose objects may be stored in the same place, and the inhaler mouthpiece, if not capped, can easily entrap and conceal these objects, placing the patient at risk for aspiration. A few previous reports have described cases of airway foreign bodies (a lid to a makeup pencil, cap of an inhaler, tablets, and coins) after use of an MDI 5–12 …”

Section: Discussionmentioning

confidence: 99%

“…Few reports in the literature describe aspiration of foreign bodies after use of MDIs. [5][6][7][8][9][10][11][12] In each case in which the foreign object was retrieved, it was found in the tracheobronchial tree. We recently treated a patient who had aspirated a foreign body after use of an MDI; however, unlike previous reports, the foreign body was found in the larynx.…”

Section: Foreign-body Aspiration Accounts For Approximately 3000mentioning

confidence: 99%

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Laryngeal Obstruction after Inhalation of a Penny from a Metered‐Dose Inhaler

Dayan¹,

Portugal²,

Walner³

et al. 1999

Otolaryngol.--head neck surg.

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“…Foreign body aspiration following unconventional use of a metered dose inhaler SPIRATION of a foreign body during use of a metered dose inhaler is a rare but recognized hazard. [1][2][3][4][5][6][7][8] In these instances, small objects inadvertently lodged in the mouthpiece of an uncapped inhaler are aspirated upon forceful inspiration. This report describes an unusual case of laryngeal obstruction after inhalation of a piece of a Turbuhaler® which resulted from a patient tampering with the device.…”

mentioning

confidence: 99%

Foreign body aspiration following unconventional use of a metered dose inhaler

Campisi

Backman

Sweet

2000

Can J Anesth/J Can Anesth

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Purpose: Aspiration of a foreign body may be life-threatening. This report describes laryngeal obstruction after inhalation of a piece of a Turbuhaler® which resulted from a patient tampering with the device.Clinical features: A 27-yr-old man disassembled a Turbuhaler® and inadvertently aspirated a plastic dispensing medication disc (22 mm diameter) while attempting to inhale the remnant terbutaline sulfate which accumulated on it. Although the patient was hoarse, he was not in acute respiratory distress. X-ray revealed the disc lodged in the larynx below the vocal cords. The patient was immediately transferred to an operating theatre, and a drying agent (glycopyrrolate), judicious sedation (midazolam and fentanyl) and O 2 were administered. The airway was anesthetized with lidocaine 4% delivered using high-flow O 2 through an atomizer. Direct laryngoscopy revealed a partially obstructed view of the disc lodged distal to the vocal cords which was inaccessible for retrieval. Loss of consciousness was subsequently induced by spontaneous mask ventilation with sevoflurane (in O 2 ). The airway was visualized using a suspension laryngoscope and the foreign body was removed with grasping forceps. The patient was awakened, transferred to the ICU and given 4 mg decadron iv every eight hours (two doses). Laryngoscopy prior to discharge indicated good mobility of the vocal cords and normal glottic structure.Conclusion: Aspiration of a foreign body is a potentially life-threatening situation requiring coordination between anesthesiologist, surgeon, and nursing staff. Anesthetic goals include avoidance of upper airway obstruction and maintenance of adequate ventilation while the foreign body is retrieved. Provisions must be made for tracheostomy if these goals cannot be realized.Objectif : L'aspiration d'un corps étranger peut être dangereuse. Dans le présent article, on décrit une obstruction laryngée survenue après l'inhalation d'une pièce de Turbuhaler®, le patient ayant modifié l'appareil.Éléments cliniques : Un homme de 27 ans a démonté un Turbuhaler® et aspiré par inadvertance un disque distributeur de médicament de 22 mm de diamètre en tentant d'inhaler du sulfate de terbutaline qui s'y était accumulé. Même si le patient était enroué, il ne présentait pas de détresse respiratoire aiguë. La radiographie a révélé la présence du disque dans le larynx, sous les cordes vocales. Le patient a été amené immédiatement en salle d'opération où il a reçu un médicament asséchant (glycopyrrolate), une sédation appropriée (midazolam et fentanyl) et de l'O 2 . Les voies aériennes ont été anesthésiées avec de la lidocaïne à 4 % administrée à l'aide d'un atomiseur d'O 2 à haut débit. La laryngoscopie directe a révélé une vision partiellement obstruée du disque logé sous les cordes vocales et inaccessible. La perte de conscience a été induite par la suite par la ventilation spontanée au masque avec du sévoflurane dans de l'O 2 . On a pu visualiser les voies aériennes en utilisant un laryngoscope à suspension et le corps étranger a été ...

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Intrabronchial tablets—Jet propelled A case report

Cited by 12 publications

References 3 publications

Aspiration of a Cigarette Filter From a Bronchodilator Inhaler

Aspiration of a Cigarette Filter From a Bronchodilator Inhaler

Laryngeal Obstruction after Inhalation of a Penny from a Metered‐Dose Inhaler

Foreign body aspiration following unconventional use of a metered dose inhaler

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