Acebecker Posted September 28, 2015 Share Posted September 28, 2015 Just thinking about my own general state of mind during emergencies and this situation came to mind - What would you do? To my knowledge, there is not a standard of Tx, other than to minimize damage until surgery can take over. As long as the airway is patent, no specific treatment in the ER or pre-hospital setting, correct? Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted September 28, 2015 Moderator Share Posted September 28, 2015 You mean it's in the oropharynx or piercing a cheek? Link to comment Share on other sites More sharing options...
Acebecker Posted September 29, 2015 Author Share Posted September 29, 2015 In the oropharynx Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted September 29, 2015 Share Posted September 29, 2015 One key take away from EM/EMS review/CME is to scan this area with any penetrating injury. Too many vascular/neuro structures, especially if penetrates in posterior pharynx. Same goes for the neck. EMEDPA, am I hallucinating again? I recall this as being automatic. Link to comment Share on other sites More sharing options...
medic25 Posted September 30, 2015 Share Posted September 30, 2015 One key take away from EM/EMS review/CME is to scan this area with any penetrating injury. Too many vascular/neuro structures, especially if penetrates in posterior pharynx. Same goes for the neck. EMEDPA, am I hallucinating again? I recall this as being automatic. Scan or direct to the OR I would say, depending on surgeon preference. For someone with a foreign body embedded in their airway (with the possibility of moving and causing significant hemorrhage in the airway), I would be very hesitant to move them to the scanner without first securing the airway. Depending on the degree of bleeding, hanger location and airway status this might be a patient that would benefit from an awake fiberoptic intubation, or someone who goes directly to a surgical airway. Link to comment Share on other sites More sharing options...
cbrsmurf Posted September 30, 2015 Share Posted September 30, 2015 Really depends, got a photo? The carotids are close by, don't know if I would try to intubate and risk lacerating the arteries. Otherwise, if pt is stable, leave them alone until head and neck get there. Also wouldn't get a scan until ENT gets there. Link to comment Share on other sites More sharing options...
Acebecker Posted September 30, 2015 Author Share Posted September 30, 2015 This is a hypothetical. I was thinking about peds specific emergencies in the prehospital setting. Link to comment Share on other sites More sharing options...
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