Chapter 1448： 【1448】Key inspection area

Chapter 1448 [1448] Key Inspection Area

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

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

The most common physiological response is the gag reflex, which is nausea and vomiting when the tongue depressor touches the back wall of the pharynx.

Prevent foreign bodies from entering the trachea by mistake and one of the most important anatomical structures in our human body is called the epiglottis. Bronchoscopy has already said about this place last time. So what I want to say now is that if there is a foreign body, most of the foreign bodies will be repelled and stuck around the epiglottis due to the physiological defense of the epiglottis.

A patient with foreign body obstruction by an experienced emergency physician will focus on this area.

Xie Wanying said, based on her previous observations in the oral cavity of the child and her preliminary judgment on the formation of the brain, "No foreign bodies were seen in the tonsils and oropharynx on both sides. No foreign bodies were seen at the junction of the base of the tongue and the epiglottis. The foreign bodies that are often mentioned in textbooks remain. There is no abnormality in the piriform fossa on both sides of the entrance of the larynx. Therefore, the blockage should have fallen into the trachea, which is expected to be in the tracheal bifurcation. The length of the trachea of ​​a five-year-old child is about five centimeters, and it is possible to use a laryngeal foreign body forceps. come get it."

worthy of being an excellent medical student, every place he said is the key point, leaving the teacher blameless. As she said, 20 to 30 percent of the foreign body will fall to the tonsils and oropharynx on both sides. Most will fall to the base of the tongue and epiglottis. As for the piriform fossa where foreign body retention is written in textbooks, it is rare.

Zhang Huayao carefully inspected these places and found no foreign objects. Of course, this is not a good thing for children. As long as the doctor does not find a foreign body, the patient will die. Now we can only hope that the foreign body falls into the trachea rather than the bronchi. As long as a direct laryngoscope can be found here, there is an opportunity to use the direct laryngoscope and foreign body forceps to remove the foreign body.

dong dong dong dong, Lin Liqiong ran back again, running to the point where 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.

"Are there any foreign body forceps?" Zhang Huayao asked.

"Yes." Lin Liqiong gasped and touched the pocket of her white coat. Maybe she was in a hurry. Her hands were shaking uncontrollably.

Xie Wanying stretched out her hand and held her hand to help her stop trembling.

"Thank you." Lin Liqiong whispered, calmed down and took out the contents in her pocket, "I can only find this."

Zhang Huayao took the equipment she found and looked carefully, and said, "No."

"This is an endotracheal intubation forceps." Cao Yong said as if he knew something was wrong.

The classification of medical devices is very detailed. Of course, there are many times when doctors use unsuitable medical equipment to do emergency treatment to patients under unavoidable circumstances. However, some are really not universal.

For example, this tracheal intubation forceps now has a round head and a relatively large cross-section. It is difficult to enter the child's trachea, but it can take out foreign bodies through the feeding tube. The anterior-posterior diameter of the trachea of ​​a five-year-old child is about eight millimeters. Taking the front and rear diameter as an example, it is because the trachea is not a straight cylinder, but a flat type. The front and rear diameter and the transverse diameter are not the same, and the transverse diameter is larger than the front and rear diameter. Both the front and rear diameters and the transverse diameters of children are much smaller than that of adults.

(end of this chapter)