Foreign body aspiration in child, next best step?

[Bagheera]

Hey

I saw a UWORLD question that asked the next best step for foreign body aspiration in a child, and one question said do flexible bronchscopy as its both diagnostic and thearpeutic whereas rigid bronchscope was recommened in a diff question as the test of choice. Which is it? thank!!

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[link2swim06]

Hey

I saw a UWORLD question that asked the next best step for foreign body aspiration in a child, and one question said do flexible bronchscopy as its both diagnostic and thearpeutic whereas rigid bronchscope was recommened in a diff question as the test of choice. Which is it? thank!!

Pretty sure if it is in the esophagus and stuck for more than 24 hours or so you can use a flexible scope to get it.

If it is in the trachea/mainstem and the kid is having decent amount of problems breathing you go to rigid scope.

 

[Rebs28]

From what I remember of UWorld and Kaplan Qbank, you should go to rigid bronchoscopy first. I remember always wanting to pick flexible and being wrong.

 

[evilbooyaa]

Were both flexible and rigid bronch answer choices in both questions?

I believe it is rigid > flexible for FBA w/ SOB. However, if something is stuck in the esophagus, however, I think flexible is the better option.

 

[drk]

In the Tracheo-Bronchial tree = Rigid Bronchoscope
In the Esophagus = Flexible Esophagoscopy

 

[JRjcu08]

My "mnemonic"

if you need to Find (diagnose) something - use Flexible
if you need to Retrieve / Remove something - use Rigid

 

[EaglesAllDay]

My "mnemonic"

if you need to Find (diagnose) something - use Flexible
if you need to Retrieve / Remove something - use Rigid

👍 Cool and unique way to remember..thanks!

 

[CDI]

My "mnemonic"

if you need to Find (diagnose) something - use Flexible
if you need to Retrieve / Remove something - use Rigid

Doesn't really work if they have a coin stuck in their esophagus.

 

[JRjcu08]

Doesn't really work if they have a coin stuck in their esophagus.

Except that aspiration implies trachea, ingestion is esophagus... And this is for a bronchoscope, not an endoscope. So yes, it does work for selecting a bronchoscope type.

A rigid endoscope sounds like a one-way ticket to esophageal perforation repair. If you're in the esophagus, it's always flexible.