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DISTRESS.. RESPIRATORY CAUSES

DISTRESS.. RESPIRATORY CAUSES. CONGENITAL. LARYNGO-TRACHEO-BRONCHIAL TREE. ETIOLOGY. USUAL VICTIMS : CHILDREN 12-48 MONTHS OF AGE . REASONS : TENDENCY TO PUT THINGS INTO MOUTH . POOR CHEWING ABILITY BECAUSE OF LACK OF POSTERIOR DENTITION.

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DISTRESS.. RESPIRATORY CAUSES

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  1. DISTRESS.. RESPIRATORY CAUSES • CONGENITAL

  2. LARYNGO-TRACHEO-BRONCHIAL TREE

  3. ETIOLOGY USUAL VICTIMS: CHILDREN 12-48 MONTHS OF AGE. REASONS: TENDENCY TO PUT THINGS INTO MOUTH. POOR CHEWING ABILITY BECAUSE OF LACK OF POSTERIOR DENTITION. TENDENCY TO HAVE FREQUENT VIGOROUS UN INHIBITED INSPIRATION WHEN STARTLED,LAUGHING & COUGHING.

  4. ETIOLOGY. (CONTD.) IN ADULTS USUALLY ACCIDENTAL WITH COUGH OR SNEEZE WHEN SOMETHING IN MOUTH. MAY OCCUR DURING SLEEP OR WHILE IN ALCOHOL INTOXICATION OR WITH EXTRACTION OF TEETH DURING LOCAL OR GENERAL ANESTHESIA. RARE VICTIMS- MENTALLY RETARDED PEOPLE.

  5. TYPES OF FOREIGN BODIES METALLIC TYPES OF FOREIGN BODIES IN TRACHEO BRONCHIAL TREE. VEGETABLE NON METALLIC NON VEGETABLE THICK SPUTUM

  6. PREVALENCE OF F.B. IMPACTION

  7. C L I N I C A L F E A T U R E S INITIALSYMPTOMS C Y A N O S I S C O U G H I N G C H O K I N G D Y S P N E A STRIDOR LATER WHEEZING DECREASED AIR ENTRY UNILATERALLY FEVER

  8. LARYNGEAL PROTECTION OF AIRWAY CESSATION OF RESPIRATION COUGH REFLEX

  9. F.B. CAUSING OBSTRUCTION AT LAYNGEAL LEVEL

  10. LARYNX SMALL F.B. PARTIAL AIRWAY OBSTRUCTION COUGH PAIN DYSPNEA IN CHIILDREN BACK TAP WITH HEAD DOWN. HEIMLISCH MANOEUVRE IN ADULTS LARGE F.B. AIRWAY OCCLUSION SUDDEN DEATH

  11. C C L I N I C A L F E A T U R E S TRACHEAL F.B. COMPLETE OBSTRUCTION NOT POSSIBLE PARTIAL OBSTRUCTION F.B. MOVES UP & DOWN WITH AIR MOVEMENT CAUSING AUDIBLE SLAP OR ASTHMATIC WHEEZE. REMOVE F.B. BY TRACHEOSCOPY

  12. C L I N I C A L F E A T U R E S BRONCHI SMALL F.B PARTIAL OBSTRUCTION TOTAL OBSTRUCTION LOBAR OR SEGMENTAL ATELACTASIS LATER EMPHYSEMATOUS BULLA MAY RUPTURE LEADING TO SPONTANEOUS PNEUMOTHORAX TOTAL OBSTRUCTION DILATATION OF AIRWAY DURING INSPIRATION PUMPING OF AIR WITH EACH INSPIRATION EMPHYSEMA LONG RETAINED F.B. MAY GIVE RISE TO: PNEUMONITIS BRONCHIECTASIS LUNG ABSCESS

  13. DIAGNOSIS

  14. RADIOPAQUE F.B. IN RIGHT LUNG ON PA VIEW.

  15. RADIOPAQUE F.B. IN BRONCHUS ON LATERAL RADIOGRAPH.

  16. A METALLIC SCREW IN RIGHT MAIN BRONCHUS.

  17. A DENTAL CROWN IN RIGHT MAIN BRONCHUS.

  18. NAIL CLIPPERS IN LEFT MAIN BRONCHUS IN AN ADULT INHALED DURING MILD EPILEPTIC SEIZURE.

  19. F.B. IN LEFT MAIN BRONCHUS CAUSING COMPLETE COLLAPSE LEFT LUNG & HYPER INFLATED RIGHT LUNG.

  20. POST F.B. REMOVAL RADIOGRAPH WITH NORMAL RIGHT LUNG & EXPANDED LEFT LUNG.

  21. PEANUT IN LEFT BRONCHUS JUST BELOW THE CARINA.

  22. PEANUT SWOLLEN UP AFTER ABSORBING SECRETIONS.

  23. MANAGEMENT SMALL LARYNGEAL, OR

  24. INDICATIONS OF TRACHEOSTOMY

  25. TO BYPASS UPPER AIRWAY OBSTRUCTION Infections Ac. Epiglottitis Ac. Laryngo- Tracheobronchitis Laryngeal – Diphtheria Ludwig’s angina. Malignancies Advanced tumors Of larynx, tongue, Pharynx with Stridor. Congenital Subglottic stenosis Laryngeal web Laryngeal cysts Tracheo esophageal Anomalies Laryngeal hemangioma. Foreign body Impaction Swallowed or inhaled Foreign bodies Impacted in upper Airway causing Stridor. Trauma Gunshot or knife Wounds of neck Inhaled irritant Fumes & smoke Swallowed corrosives. Vocal cord paralysis Operative complications Of Thyroid, cardiac & Esophageal surgeries Bulbar palsy.

  26. TO ASSIST VENTILATION • COMA • WITH • HEAD • INJURY • GCS,8 BARBITURATE POISOING TETANUS POLIOMYELITIS

  27. TO FASCILITATE TRACHEOBRONCHIAL TOILETING

  28. TO PROTECT AIRWAY ELECTIVELY BEFORE MAJOR HEAD AND NECK SURGERIES

  29. TECHNIQUE INCISION. DIVISION OF SUBCUTANEOUS TISSUE & DEEP CERVICAL FASCIA. SEPARATION OF STRAP MUSCLES. DIVISION OF THYROID ISTHMUS. INCISION IN THE TRACHEA. INSERTION OF TRACHEOSTOMY TUBE. CLOSURE OF THE WOUND. ANIMATION VIDEO OF THE TRACHEOSTOMY PROCEDURE

  30. ANYQUESTIONS?

  31. THANKS

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