Beans have friends and only one came back out. I'd
push for a scope in the ED after at least an x-ray
series. Heck, I'd probably get those tests even
without his symptomatolgy on history alone. Of course
we got burned on one like this only a few months back
so I'm extra cautious now.
Robert Dudas MD
Johns Hopkins Bayview Medical Center
--- Maureen McCollough Hill <[log in to unmask]> wrote:
> Case for the group:
> 2 yr old child presents to ED after choking episode
> at home. Child was
> playing with beans from a daycare arts-and-crafts
> and suddenly choked. Mom
> sees child having trouble breathing and performs a
> Heimlich. Out pops a
> bean. Child still with stridor and wheezing. Mom
> brings kid to ED. In ED
> for 3 hrs. Still has "audible stridor and wheezing"
> during ED stay. Maybe
> improves with Albuterol, but not completely. Child
> maybe has a history of
> "asthma" prior to this choking episode. No prior
> admits for asthma. Child
> well prior to choking episode. Child admitted to
> peds floor for
> "observation" with albuterol. ED diagnosis on chart
> 1. Foreign body
> aspiration, 2. Bronchospasm
> No xrays, no bronchoscopy, just observation with
> of care??
> Maureen McCollough
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