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Rule out airway foreign body

Nearly 3 year old girl was eating nuts and had a coughing episode. 6 year old sibling told parents “she’s choking on the nuts.” In the ED, patient is completely asymptomatic, has a normal CXR and a 100% O2 sat on room air.

3yo choking episode, asymptomatic, CXR neg. How would you disposition this child?

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pemsou5_wp • August 30, 2016

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  1. Kelly August 31, 2016 - 5:47 am Reply

    Virtual bronchoscopy using a low dose multidetector CT has a high positive predictive value for airway foreign body diagnosis: Mucous plugs can produce false positives. The lack of invasiveness of CT is balanced by the radiation risk, which according to, the additional cancer risk for a low dose chest CT in a 2yo female would be 1 in 1446, and for a 2yo male 1 in 2641. Time for shared decision making with the parent/guardian!

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