Chapter 1448 [1448] Key Inspection Areas

"You said the blockage is not in the throat?" Zhang Huayao asked Xie Wanying while observing vigorously.

Blockages generally do not fall into the trachea immediately, which is why foreign bodies in the airway are common, but suffocation is not uncommon when it falls into the trachea. The physiological response and structure of the human body are effective in preventing the accidental swallowing of foreign bodies in daily life.

The most common physiological reaction is gag reflex, that is, touching the posterior pharyngeal wall with a spatula will cause nausea and vomiting.

One of the most important anatomical structures in our body to prevent foreign bodies from entering the trachea is called the epiglottis. The last bronchoscopy has already mentioned this place. So what I want to say now is that if there are foreign bodies, due to the physiological defense function of the epiglottis, most of the foreign bodies will be repelled and stuck around the epiglottis.

An experienced emergency physician who encounters a patient with a foreign body obstruction will focus on examining this area.

Xie Wanying said based on her previous observations in the child's mouth and the preliminary judgment of brain formation: "There is no foreign body in the tonsils and oropharynx on both sides. There is no foreign body at the junction of the tongue base and epiglottis. The foreign body that is often said in textbooks remains. There is no abnormality in the pyriform fossa on both sides of the larynx entrance. Therefore, the blockage should have fallen into the trachea, and it is expected to be in the trachea bifurcation. The length of the trachea of ​​a five-year-old child is about 5 cm, and it is possible to try using a foreign body forceps Come get it."

As expected of an excellent medical student, everything he said was full of key points, making the teacher blameless. As she said, 20 to 30 percent of the foreign body will fall into the tonsils and oropharynx on both sides. Most will fall to the base of the tongue and epiglottis. As for the piriform sinuses where the foreign body remains in the textbook, it is rare.

Zhang Huayao carefully inspected these places and found no foreign objects. This is of course not a good thing for the child. As long as the doctor does not find the foreign body, the patient will die. Now we can only hope that the foreign body falls into the trachea instead of going to the bronchi. As long as a direct laryngoscope can be found here, there is a chance to use the direct laryngoscope and foreign body forceps to remove the foreign body.

Boom, boom, boom, Lin Liqiong ran back again, until she was about to lose her breath. This time, after opening the small blue box she brought in, she finally lived up to expectations and brought a direct laryngoscope.

"Do you have foreign body forceps?" Zhang Huayao asked.

"Yes." Lin Liqiong was panting while touching the pocket of her white coat, maybe she was too anxious, her hands were trembling uncontrollably.

Xie Wanying reached out her hand and held her hand to stop her trembling.

"Thank you." Lin Liqiong said in a low voice, she steadied herself and fumbled out the contents of her pocket, "I can only find this."

Zhang Huayao took the equipment she found and looked at it carefully, and said, "That's not right."

"This is an endotracheal intubation forceps." Cao Yong looked at it and knew it was wrong, and said.

The classification of medical devices is very detailed. Of course, in many cases, doctors use inappropriate medical equipment to give emergency treatment to patients when they have to. However, some are really not universal.

For example, the current endotracheal tube forceps has a round head and a relatively large cross-section. It would be choking if it goes into a child's trachea, but it can take out foreign objects through the feeding tube. The front-to-back diameter of the trachea of ​​a five-year-old child is about 8 mm. To take the anteroposterior diameter as an example, the trachea is not a right cylinder, but a flat one. Regardless of the front-to-back diameter and transverse diameter, children are much smaller than adults' more than a dozen.