Describe CPR.
Chest compressions may dislodge the object by raising intrapulmonary pressure.
Attempt to remove the FB while CPR is ongoing.
Head-tilt/chin-lift maneuver to open the airway
At every 2-minute pulse check, check the airway for a dislodged FB; remove if present.
Do not perform blind finger sweeps if a FB is not visible. [13]
Attempt laryngoscopy-guided FB retrieval.
What is the indication for emergency airway procedures?
failed first-aid attempts to dislodge the FB
Describe laryngoscopy.
Laryngoscopy-guided FB retrieval: Under direct laryngoscopy, attempt to remove any visible FB with Magill forceps.
Inability to remove FB with forceps: Intubate using an endotracheal tube (ETT) to displace the FB as distally as possible into either main bronchus.
Successful distal displacement: Withdraw the ETT to the standard tip-to-lip distance and ventilate if possible.
Unsuccessful distal displacement: emergency surgical airway
Laryngoscopy risks converting a partial obstruction into a total obstruction by displacing the object or causing laryngeal trauma and/or hemorrhage
Describe the emergency surgical airway.
Indication: failure of the above maneuvers to remove the FB in an unresponsive patient
Options
Adults: scalpel cricothyroidotomy (or emergency tracheotomy if expertise is readily available)
Infants and children < 12 years old: needle cricothyroidotomy
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