Famous Among Top Surgeons in the 90s Chapter 1448: 1448: Key Inspection Areas

Chapter 1448: Chapter 1448: Key Inspection Areas

“You said the obstruction is not in the larynx?” Zhang Huayao asked Xie Wanying urgently as he examined with effort.

Typically, obstructions do not imdiately fall into the trachea, which is why airway foreign bodies are common, but it is not very common for them to fall into the trachea and cause suffocation. The physiological reactions and structure of the human body effectively prevent accidental swallowing of foreign objects in everyday life.

The most common physiological response is the gag reflex, where touching the back of the throat with a tongue depressor causes nausea and vomiting.

Another critical anatomical structure to prevent foreign objects from going into the trachea is the epiglottis. This was discussed during the previous bronchoscope session. Now, if there is a foreign body, due to the physiological defense chanism of the epiglottis, most foreign bodies are repelled and caught around the epiglottis area.

An experienced ergency doctor encountering a patient with foreign body obstruction will focus their examination in this area.

Based on her prior observation of the child’s oral cavity and her preliminary judgnt, Xie Wanying said, “No foreign bodies were found in the tonsils on either side or in the oropharynx. No foreign body seen at the junction of the tongue root and epiglottis. The textbook often ntions the lodgnt locations, but no abnormalities found in the pyriform sinus on either side of the laryngeal entrance. Hence, the obstruction must have fallen into the trachea, likely at the tracheal bifurcation. A five-year-old child’s trachea is about five centiters long, so it’s feasible to attempt removal with the laryngeal foreign body forceps.”

Indeed, an outstanding dical student, she ntioned all the key points leaving the teacher uncriticizable. As she stated, twenty to thirty percent of foreign bodies fall into the tonsils on either side and the oropharynx. Most fall into the tongue root and epiglottis. As for the rare sites noted in textbooks, like the pyriform sinus, it’s less common.

Zhang Huayao carefully examined these areas and found no foreign body present. This was certainly not good news for the child; as long as the doctor doesn’t find the foreign object, the patient remains in life-threatening danger. Now, there is only hope that the object has fallen into the trachea rather than the bronchus. If found here, there’s an opportunity to use the direct laryngoscope and foreign body forceps to remove it.

Thump thump thump, Lin Liqiong ran back again, nearly out of breath. This ti she opened the blue small box she brought in, and finally brought the direct laryngoscope, lived up to everyone’s expectations.

“Do we have the foreign body forceps?” Zhang Huayao asked.

“Yes.” Lin Liqiong said, panting, while touching the pocket of her white coat, possibly too hurried, her hand trembled uncontrollably.

Xie Wanying reached out her hand, held her hand to stop the tremor.

“Xie Xie.” Lin Liqiong whispered, cald down and pulled out the item from her pocket, “I could only find this.”

Zhang Huayao took the instrunt she found and examined it closely, “It’s not right.”

“This is an endotracheal forceps,” Cao Yong knew just by looking at it and said.

dical instrunts are classified ticulously. Often in dire situations, doctors use inappropriate instrunts for ergency treatnt. However, so are truly not interchangeable.

For example, this endotracheal forceps has a rounded head with a larger cross section, which makes entering a child’s trachea unlikely, but it can be used for esophageal foreign body retrieval. The front-to-back diater of a five-year-old child’s trachea is around eight milliters. The reason for ntioning the front-to-back diater is because the trachea is not a perfect cylindrical shape; it’s flattened with different front-to-back and dial-lateral diaters, with the dial-lateral diater larger than the front-to-back. Whatever the front-to-back and dial-lateral diaters, they are notably smaller in children than in adults.