Management of emergency vs. Otorhinolaryngology department tracheobronchial foreign-body aspiration

Foreign-body aspiration (FBA) obstructing the airways may lead to choking and cardiopulmonary arrest without immediate emergency care. We retrospectively reviewed medical records of 17 otorhinolaryngology subjects-8 men and 9 women aged 0 to 84 years-88% of whom were<3 years old, requiring tracheobronchial FBA between January 1995 and October 2006 and of 62 emergency subjects-43 men and 19 women aged 0 to 91 years-10% of whom were<3 yeares old 68% of whom ≥ 50 years old, admitted between January 2000 and October 2006. Emergency Department personnel saw a mean of 8.9 patients per year versus the mean of 1.4 patients per year seen by Otorhinolaryngology Department personnel. Foreign bodies extracted most frequently from the 17 otorhinolaryngology patients were 9 seen for peanut injestion followed by 1 each seen for bean, screw, and false teeth injestion among other objects. Sixteen of the 17 were discharged without complications. Foreign bodies extracted from the 62 emergency patients most frequently involved food, especially rice cakes. Over half seen had already gone into cardiopulmonary arrest upon arrival and required cardiopulmonary resuscitation. Of the 62, 32 patients died, 13 were sent to another hospital after in-patient care, 9 were sent home without admission, and 7 were discharged without complications.