Rules for removing a foreign body from the respiratory tract. Methods for removing foreign bodies from the respiratory tract. External auditory canal

Try to remove the foreign body with the index finger or fingers II and III inserted into the pharynx to the base of the tongue in the form of tweezers;
If there is a suction, then clean the oral cavity with it.
With the patient on his side, perform 4-5 strong strikes with the palm of your hand between the shoulder blades.
In a supine position, perform several active pushes into the epigastric region from bottom to top in the direction of the chest.

The airways can be cleared of liquid or semi-liquid media (blood, vomit, mucus) by laying the patient on his side. However, if a neck injury is suspected, the head, neck and chest should be in one line at all times to avoid injury to the cervical spinal cord.

In case of aspiration of a solid foreign body, they try to remove it using the following techniques:

if the victim is conscious, then

They ask you to clear your throat;

The victim is covered from behind with his arms, placing the fist of one hand above the patient’s navel,

and the other hand over the fist and make several compressions - this Heimlich maneuver.

In pregnant and obese people, the resuscitator’s fist during this technique is located in the middle of the sternum and the victim’s chest is compressed.

Small children and newborns, in case of foreign body aspiration, are lowered face down, supported by one hand and knee, and blows of moderate force are applied between the shoulder blades with the palm of the other hand.

If the necessary conditions are available (equipment and trained personnel), in the case of obstruction of the respiratory tract by foreign masses, it is preferable to perform tracheal intubation, and if this is not possible, cricothyrotomy (conicotomy).

Stage B – restoration of breathing, mechanical ventilation.

If, after restoration of airway patency, spontaneous breathing has not been restored, begin mechanical ventilation, which is carried out using the expiratory method (mouth to mouth, mouth to nose). Old techniques (Sylvester and others), based on changes in chest volume, are ineffective and should not be used.

When performing mechanical ventilation, the minimum required volume of one passive breath, which allows to straighten the alveoli and stimulate the activity of the respiratory center, is considered to be 1000 ml. The intervals between breathing cycles should be 5 seconds (12 cycles per minute).

You should not blow air as often as possible; it is important to ensure a sufficient volume of artificial inspiration.

When performing mechanical ventilation, the following rules should be observed:

It is necessary to ensure the tightness of the system “the lungs of the victim - the lungs of the resuscitator.” If the victim's mouth or nose is not tightly covered by the resuscitator's lips, then air will escape out. Such ventilation will be ineffective.
Constant monitoring is possible while ensuring airway patency.

As an alternative technique, insufflation can be carried out through an anesthesia mask, an S-shaped tube, using an Ambu bag.

Such an extremely unpleasant situation as a foreign object entering the respiratory tract (nasopharynx, larynx) occurs quite often. It is more likely to occur in children under 5 years of age. It is at this age that he actively explores the world around him, using not only his hands, but also his mouth. There is also a possibility that a small object may simply be inhaled by a child.

At an older age, a foreign body enters the respiratory tract during games, jokes, eating too quickly, or unsuccessful experiments. How to behave in such a situation, how to help the victim, and what first signs you should pay attention to, we will consider in this article.

Main symptoms

Depending on the size of the foreign object in the respiratory tract, it can completely or partially close it, blocking the access of oxygen to the lungs. In addition, a foreign body can injure the larynx and vocal cords, causing inflammation and swelling, thereby worsening the situation. With the partial version, breathing will be heavy, labored and intermittent. Sometimes a person can take a breath, but instead of exhaling there will be a creak or a whistle. The most dangerous situation is when a foreign object completely blocks the breathing process, blocking the lumen of both bronchi at once. In this case, there is a high risk of death.

How can you understand that the cause of suffocation is a foreign body, and not a severe allergic reaction, for example?

Signs of a foreign body in the respiratory tract

A sharp and sudden change in behavior. Movements become chaotic. The person usually grabs his throat and loses the ability to speak.
Redness of the facial skin, enlarged veins in the neck
Coughing as an attempt by the body to get rid of an object
Breathing is difficult. When you inhale, you can hear strong wheezing
Due to a sharp lack of oxygen, the skin above the upper lip may acquire a bluish tint.
Rapid loss of consciousness

Such symptoms are characteristic of the active phase when the airways are completely blocked, if the object has stopped in the larynx or trachea. The disease develops sharply, and assistance must be provided as quickly and effectively as possible.

If a small object, during a sharp inhalation or cough, passes through the larynx and gets stuck in the bronchi, then the first sharp external symptoms may be absent or appear from time to time. In this case, a sluggish inflammatory process occurs, which may be accompanied by: increased temperature, short-term attacks of asphyxia, coughing attacks, shortness of breath, and vomiting. The cause can only be determined using x-rays.

It should be remembered that if assistance is provided incorrectly, you can displace a foreign object deeper, and thus only worsen the victim’s condition.

Foreign body in the respiratory tract and first aid

***The Heimlich maneuver is a miraculous method developed by the American physician Henry Judah Heimlich in 1974. This is a method of providing assistance to a victim, used to quickly clear a person’s respiratory tract from foreign body objects or food debris. The technique is based on creating pressure in the abdominal cavity of the victim’s abdomen, which allows the foreign body to be pushed out of the oropharynx. This method is discussed in more detail in the video presented.

The article is for informational purposes only, you perform all actions at your own peril and risk, remember that qualified assistance from specialists has not been canceled!

A very useful video, by watching it you can save someone’s life!

Unforeseen situations may arise during dental treatment. Sometimes patients come to the clinic complaining of pain in a previously treated tooth. An X-ray examination may reveal that there is a foreign body in the tooth canal. It also happens that until a certain moment the patient does not suspect such a “treasure” hidden in one of the dental units, since it does not reveal itself in any way.

If a foreign body is noticed in the cavity of a tooth or dental canal, it is recommended to remove it immediately.

What is a foreign body

Various objects can act as a foreign body. Most often this is:

fragments of professional instruments that the dentist used during tooth treatment - perhaps these are the most common objects “forgotten” in the tooth canal;
pins that were previously used to fill dental canals;
fragments of an incompletely removed root.

Absolutely any material that was used during restorative or therapeutic manipulations with a damaged tooth is a foreign body. Over time, it wears out, undergoes corrosive processes and becomes dangerous to the health of the tooth. Anchor and fiberglass pins, old inlays, and fragments of instruments can cause a crack to form in the canal, which can lead to future tooth loss. To avoid such an outcome, the foreign body must be promptly removed from the dental canal.

Quite often it is necessary to remove the anchor pin, which is a rod made of titanium or alloys of other metals, and is used in cases where it is necessary to restore a damaged dental crown. Violations of operating rules usually lead to destruction and wear of the structure.

Reasons why foreign bodies end up in the tooth canal

Foreign particles may remain in the dental canal during complex endodontic treatment due to the following situations:

The channels are quite narrow and have a tortuous shape. The dental instrument cannot withstand the pressure and breaks off.
During manipulations to clean the dental canal from the dead nerve or blood vessels.
If work is carried out using hand tools, when there is a possibility of parts breaking due to thinning of the metal or the presence of defects.

Of course, the failure of dental instruments is not the norm in the treatment process, but such a risk does occur.

Signs indicating the presence of foreign particles in the dental cavity

Immediately at the moment when a piece of a foreign object ends up in the tooth canal, the patient is not able to feel any changes; initially, there are no symptoms at all. However, after some time, the process of metal corrosion begins, accompanied by inflammation. That's when the first signs appear.

Constant irritation of the dental cavity provokes root destruction. In such conditions, it is not always possible to save a tooth.

Symptoms that you should pay attention to and respond promptly

Typical symptoms include the following:

painful sensations when biting or chewing food - indicate the beginning of the internal periodontal process, that is, the purulent contents put pressure on the dental unit;
swelling of the gum tissue is noted;
a fistula appears, through which pus enters the oral cavity; this process reduces tooth pain for a while, but it is a mistake to believe that there is an improvement.

During a visual examination, the dentist is interested in the patient’s nature of pain, and thanks to an x-ray, he finds out what foreign object is and where exactly it is located.

Particles of broken instruments are foreign bodies that must be removed. Moreover, the occurrence of corrosion, which provokes root cracking and further tooth loss, is not the only unpleasant complication.

Due to the presence of a fragment in the root canal of the tooth, it is impossible to carry out a full filling. The main consequence is associated with the resumption of the inflammatory process, which invariably accompanies the current situation. If part of the inflamed pulp remains under a foreign object, rotting occurs. This phenomenon requires immediate professional intervention.

Easy extraction

Before proceeding with the actual removal of the debris, the doctor tries to provide easy access to the foreign body. After successful completion of the preliminary stage, part of the instrument stuck in the cavity of the dental canal is loosened and tried to be moved away from the dentin. At this stage, the use of ultrasonic dental equipment is optimal. After this, the specialist grabs the tip of the object using a special device and removes it from the cavity. The opened wound is subject to further therapeutic treatment.

Whether the extraction will be simple or difficult depends on what kind of object is to be removed from the canal.

Simple extraction is used when it comes to broken pins. They are removed quite easily. For this purpose, the dentist, using ultrasonic influence, frees the cavity from the previously used filling material, and for some time loosens the foreign object with a large amplitude. This happens with the help of ultrasound and with the obligatory use of cool water pressure, which avoids overheating of the tooth tissues. After achieving sufficient mobility of the fragment, the doctor easily removes the foreign body.

Do you have pain in a previously filled tooth? Does the process of biting and chewing food cause discomfort? Don't hesitate to solve the problem! Make an appointment at the Diamantdent dental clinic! Our specialists will quickly and efficiently examine and re-treat the inflamed tooth!

What signals the possible presence of fragments of endodontic instruments inside a tooth?

Immediately after completing the dental treatment process, patients do not feel a foreign object stuck in the root canal. The first symptoms begin to appear when the process of metal corrosion begins.

At this time, patients begin to worry about:

soreness of the dental unit caused by mechanical impact on it (including biting off hard foods and chewing food);
swelling of the mucous membrane directly around the treated tooth;
formation of a fistula, accompanied by the release of purulent contents.

To assess the condition of the tooth and confirm suspicions about the presence of a foreign object inside, the dentist prescribes an x-ray examination. If a fragment of an instrument is detected in the image, the installed seal should be opened, the foreign body removed, thoroughly cleaned and re-sealed.

Complex extraction

Technological features of the process of removing broken pieces of instruments depend on the parameters of the stuck element and the degree of neglect of the pathological process. In the case of a fairly small fragment, extraction is not easy. Therefore, it is called “complex extraction”. In such a situation, the doctor is forced to use a special dental microscope. This “jewelry” work should be entrusted to a professional. He will take care of creating access to the stuck piece of metal. To achieve this goal, the dental canal is prepared in such a way as to prevent damage to the root. When using high-frequency ultrasound at medium or low amplitude, the instrument found in the canal cavity is cleaned and loosened.

They say that the doctor’s cynicism goes beyond all limits. Our conversations make our friends' hair stand on end when they come into the staff room. Illness and death are a common reason for us for endless jokes and jokes. But even among doctors there are topics on which it is not customary to be ironic and mention them once again. One of them is death from asphyxia. In this article we will look at the most common cause of suffocation - a foreign body in the respiratory tract, and tell you how to provide first aid.

Death from asphyxia. No one is safe

In the overwhelming majority of hospital patients, the process of dying from asphyxia lasts in several stages and most often, before the last heartbeat (not breathing, since they are on mechanical ventilation), they are in an unconscious state.

Dying from suffocation in out-of-hospital conditions until the last moment conscious, they feel their respiratory muscles “tearing” while trying to take a breath. They feel like a pulse wave is beating like a hammer in their head, the blood vessels in their eyes burst from tension. A person who has recently been completely healthy understands that he is about to die, and this terrifies him. And only at the very last moment he falls into a black void...

Unfortunately, one of the reasons leading to misfortune is a completely everyday reason - a person choked on food.

Probably, the Creator did not design our body very successfully, connecting the respiratory and digestive tracts into one tube. Only a thin petal, the epiglottis, protects the respiratory organs from harm. On the other hand, it is not known how the process of our development and transmission of information would be transformed if we had a facial skeleton with rigidly separated tracts? Perhaps someone with imagination and artistic talent will depict a viable creature with a similar facial skeleton, and for now we will continue our story.

Today we are the way we were created, no matter - in the course of evolution or in the design bureau of the divine academy, and we will have to come to terms with this. But it is curious that in animals the “got into the wrong situation” conditions are extremely rare. No, my dog chokes when he swallows an incredibly large piece of meat, but he coughs it up on his own and calmly eats on. When dividing the prey, lions in a pride tear kilogram pieces of meat and swallow without choking. How? After all, the overall structure of our skeleton is similar?

I come to the conclusion that our ancestors were very, very right when they said: “When I eat, I am deaf and dumb.” After all, during a conversation, the epiglottis momentarily opens the entrance to the trachea, and this will be enough to make you choke while inhaling.

However, in medical practice there are more exotic cases: for example, a woman was eating kebab, and a piece of meat got stuck in her upper esophagus. She did not suffer from asphyxia and could have easily gone to the hospital. But our people are not looking for simple solutions. The woman grabbed a billiard cue and pushed the piece lower. Have you already introduced this process? A terribly erotic sight. The only problem is that she tore her esophagus, giving herself mediastinitis. Until now, few people survive this condition, but she was lucky.

Children - special attention!

Small children. Oh, these creatures who are always in good shape. They are always trying to get somewhere, crawling into cracks where an adult is afraid to look. They have no fear, they have no sense of self-preservation at all! They are constantly learning something, putting everything in their mouth to try and hide.

Back in our student years, a teacher on ENT diseases told us: “Guys, buy your children shirts and blouses with a pocket on the chest. They definitely need to hide their find, and if there is no pocket, then in their mouth.” All pediatric endoscopists have collected a collection of findings from the respiratory tract, including the trachea, larynx, and nose. And ENT doctors supplement these collections with objects extracted from the outer ear.

What about children? Don’t leave them alone, take away small things - that’s the only way! And do not let them eat something that is not intended for their age, understand - the digestive system, ready to accept liquid milk, is not yet ready to accept sausage.

Sometimes adults surprise us with their carelessness. Several years ago, while on a business trip to a small hospital, which is not always accessible by car, and airplanes are limited by meteorological conditions, I received a two-year-old baby. He was restless and coughed constantly. It turned out that his grandmother had been giving him unshelled sunflower seeds to husk since he was one and a half years old! She was still very surprised when we told her everything we thought about it.

So simple carelessness almost led to tragedy. We then observed the baby, waited for the endoscopists to arrive, and prepared resuscitation equipment, since it was impossible to predict the reaction of the bronchi. Only twelve hours later did regional specialists manage to reach the village. Under general anesthesia, a large seed was removed from the right bronchus; it floated in rhythm with breathing.

The boy was lucky; it often happens that a foreign body cannot be removed and it remains in the lung. Subsequently, such patients often develop pneumonia, bronchitis, and asthma.

First aid procedure

So, what should you do if you choked and a piece of food got into your larynx and blocked your airway?

Cough, if your child is over one year old, ask the child to cough. At the same time, do not shake or slap on the back, do not make the piece fall further.

If it doesn’t help, ask the sufferer to open his mouth, squeeze out the tongue with your finger, if you are sure that you can get it out, get it out! If there is no confidence and breathing is relatively unaffected, let specialists take care of the victim - do not take risks!

If the patient becomes weaker, turns blue, the cough decreases, and the ambulance is still on the way, then you need to act yourself!

Stand from behind, grab the patient at waist level, and clench one hand into a fist, so that the fist is slightly above the navel, but in the center (otherwise, with a sudden movement, you risk tearing the liver!). With your other hand, firmly grasp the fist of your hand and sharply push yourself upward, this will create high pressure in the respiratory tract, which should squeeze out the foreign body as if from a cannon. Do this several times until the piece comes out, until the doctor arrives, or in the worst case, until the person being resuscitated loses consciousness.

If all else fails, the person has lost consciousness and does not respond to a shake - do not panic, there is still a chance of salvation! Place the patient on a hard surface, unbutton the shirt, open the mouth, squeeze out the tongue, see if the foreign body can now be removed. If you see it, be sure to try to remove it, since time is not on your side in such a situation.

Tilt your head back, pull your jaw up, listen for breath. No breath? Turn the victim's head to one side or the other. No breathing? Place a napkin on his mouth, pinch his nose, and slowly inhale a portion of your air into the patient. If your chest rises, carefully continue to breathe and wait for the ambulance to arrive.

If the chest does not rise in response to your inhalation, stand at the patient’s knees, place your palms in the middle of the abdomen just above the navel and sharply press down and at the same time towards the head, as if pushing out a foreign body, and so on ten times in a row. Then look in your mouth to see if a foreign body has come out? If not, try artificial respiration again. Then press on your stomach again.

Even if you managed to remove the foreign body, take the patient to the hospital in any case, because hypoxia could damage the internal organs, you could damage the internal organs, or a piece of the foreign body could remain in the respiratory tract. Be sure to bring it!

Vladimir Shpinev

Photo 1 - thinkstockphotos.com, 2-3 - by the author

One of the most critical pathologies that anyone can encounter is a foreign body in the respiratory tract. Emergency assistance in these situations should be provided instantly - in the first seconds. Certain maneuvers that anyone can master can save the lives of adults and children if applied immediately.

This pathology develops many times more often in pediatric patients. This is due to the behavioral characteristics of babies - while eating they tend to play, talk, laugh or cry, and cough. In addition, children very often put various small objects in their mouths, which they can then accidentally inhale. The anatomical features of the oral cavity and the underdevelopment of protective reflexes in children also contribute to the increased incidence of aspiration (inhalation) of foreign bodies in young patients.

Adults most often suffer from this pathology when greedily absorbing food without chewing it or when actively talking while eating. Another “aggravating circumstance” is alcohol intoxication, which reduces the activity of the nerve centers responsible for protective reflexes.

Symptoms of a foreign body in the respiratory tract

The peculiarity of this pathology is that most often it occurs while eating. This is important information that allows us to assume that a person loses consciousness precisely as a result of a foreign body, and not, for example, a heart attack (although this is also possible).

The clinical picture of a foreign body goes through three stages in its development:

initial stage, in which there is a sudden strong paroxysmal cough, lacrimation, redness of the face;
development– the cough becomes stronger, there is practically no breathing, although the patient makes breathing movements, cyanosis appears around the lips;
final stage, during which breathing stops, the person loses consciousness, after a short time cardiac arrest is observed, followed by clinical death.

How to recognize a foreign body in the respiratory tract by external signs

The moment a foreign body enters the respiratory tract looks like this:

suddenly the person stops talking, laughing, screaming or crying, and grabs his throat with his hands;
a severe cough occurs, the victim stops answering questions;
when the victim tries to breathe, either wheezing is heard or nothing is heard; the victim opens his mouth wide, but cannot inhale;
the face, initially red, quickly becomes pale, and then acquires a bluish color, especially in the area of the upper lip);
within a few tens of seconds, loss of consciousness occurs due to respiratory arrest;
in a very short time the heart stops working and clinical death occurs.

First aid for foreign bodies in the respiratory tract

A person who knows how to recognize this pathology will not waste a second. The situation is developing rapidly and delay in providing first aid can cost the victim his life.

The algorithm of actions for this pathology is as follows:

Contact the victim with the question “What happened?” You may look stupid, but in reality this question is needed to understand whether the person is breathing at all. Your further tactics will depend on this.
If a person is somehow breathing, encourage him with the words “Cough, harder, more, come on” - any words that will “break through” to his consciousness. Often this is enough for a small foreign body that has entered the upper respiratory tract to come out on its own.
If spontaneous release of FB does not occur within 30 seconds or if the person is not breathing from the very beginning, then the Heimlich maneuver should be applied.

Heimlich maneuver

The technique for doing it is as follows:

Stand behind the victim.
Grasp his torso with both hands, cover the fist of your right hand with the palm of your left hand, and use the knuckle of your right thumb to press five firm pressures on the upper abdomen. Direction – up and towards yourself. Restoration of breathing is a sign of removal of the foreign body from the respiratory tract.

Note: The Heimlich maneuver should be performed until the FB leaves the airway or until the person loses consciousness. In the latter case, attempts to remove the foreign body should be stopped and instead.

Features of the Heimlich maneuver in children and pregnant women

When removing a foreign body from the respiratory tract in children under 1 year of age, the rescuer must sit down, place the child on the left forearm, face down, holding the baby’s lower jaw with his fingers folded into a “claw.” The baby's head should be below the level of the body. After this, you should apply five medium-force blows with the heel of your palm to the interscapular area of the back. The second stage - the child turns face up on the right forearm, after the forehead the rescuer makes five pushing movements along the sternum to a point located 1 finger below the internipple line. Don't press too hard to avoid breaking your ribs.

If a foreign body appears in the oropharynx, it is visible and can be removed without the danger of pushing it back - it is removed. If not, repeat the entire cycle either until IT appears or until cardiac arrest, after which cardiopulmonary resuscitation must begin

In children 1-8 years old, the Heimlich maneuver is performed by placing the child on the rescuer's thigh. The remaining actions are performed according to the general rules.

You will receive more detailed information about emergency care for a child if a foreign body enters the respiratory tract by watching a video review by pediatrician Dr. Komarovsky:

An important question: “What if a pregnant woman was injured?” Indeed, pressing on the belly of a woman who is heavily pregnant is guaranteed to lead to serious complications. In this case, the pressure is applied not to the stomach, but to the lower part of the sternum, as in infants.

Typical mistakes when removing foreign bodies from the respiratory tract

The first thing that comes to mind when a foreign body enters the respiratory tract is to knock on the back. The correct algorithm for how to knock is described above. However, most of us simply pound our backs as hard as we can. The danger of this method is that any foreign body is affected by gravity. Incorrect tapping may cause the FB to penetrate lower into the tracheobronchial tree and may cause complete obstruction of the airway. First aid in this case is to perform a tracheotomy, and even if by some miracle a qualified specialist is nearby, the chance of saving the victim will become scanty.

Never turn your baby upside down to shake him. Spasm of the larynx reduces your attempts to remove the foreign body to zero. Instead, you may dislocate your baby's cervical vertebrae. The fact is that when a child loses consciousness, the tone of the neck muscles decreases; during shaking, his head begins to dangle in all directions, which can lead to dislocation of the cervical vertebrae and even their fracture. By saving a baby from death, you risk making him disabled or even killing him.