TY - JOUR
T1 - A fish way out of water
T2 - Case report of a unique airway foreign body
AU - Gantwerker, Eric A.
AU - Hamilton, Steven S.
AU - Casper, Keith A.
PY - 2014/4
Y1 - 2014/4
N2 - Background: Since the time of Chevalier Jackson, innumerable unique foreign bodies have been documented and removed. Advances in endoscopic airway management have revolutionized the types of foreign bodies that we are able to remove without open surgery. The literature on fish aspiration has mostly encompassed fish bones and parts, not whole live fish. Objective: This study aimed to describe the airway management of a high-risk airway foreign body including the mobilization and coordination of multiple specialty teams and anesthetic management. Case Report: We report a case of a 40-year-old man who aspirated a live bluegill fish while attempting to use it as bait. The spike-like nature of the bluegill dorsal fin in conjunction with mediastinal air prompted a higher level of concern for potential airway compromise and complication with extraction. We detail the preparation and management of this patient from notification to transportation and ultimately operative intervention. Focus is placed on coordination between anesthesia, otolaryngology, and cardiothoracic surgery, and the key management decisions. Conclusion: High-risk airway foreign bodies are always a challenge. When dealing with a live, lodged whole fish, one must have creative management ideas. Close coordination and excellent communication must occur between teams involved to optimize and maintain control of the situation for the best patient outcome.
AB - Background: Since the time of Chevalier Jackson, innumerable unique foreign bodies have been documented and removed. Advances in endoscopic airway management have revolutionized the types of foreign bodies that we are able to remove without open surgery. The literature on fish aspiration has mostly encompassed fish bones and parts, not whole live fish. Objective: This study aimed to describe the airway management of a high-risk airway foreign body including the mobilization and coordination of multiple specialty teams and anesthetic management. Case Report: We report a case of a 40-year-old man who aspirated a live bluegill fish while attempting to use it as bait. The spike-like nature of the bluegill dorsal fin in conjunction with mediastinal air prompted a higher level of concern for potential airway compromise and complication with extraction. We detail the preparation and management of this patient from notification to transportation and ultimately operative intervention. Focus is placed on coordination between anesthesia, otolaryngology, and cardiothoracic surgery, and the key management decisions. Conclusion: High-risk airway foreign bodies are always a challenge. When dealing with a live, lodged whole fish, one must have creative management ideas. Close coordination and excellent communication must occur between teams involved to optimize and maintain control of the situation for the best patient outcome.
KW - Airway control
KW - Airway management
KW - Airway obstruction
KW - Bronchoscopy/methods
KW - Foreign bodies/surgery
UR - http://www.scopus.com/inward/record.url?scp=84903549473&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84903549473&partnerID=8YFLogxK
U2 - 10.1177/0003489414524167
DO - 10.1177/0003489414524167
M3 - Article
C2 - 24671477
AN - SCOPUS:84903549473
SN - 0003-4894
VL - 123
SP - 232
EP - 234
JO - Annals of Otology, Rhinology and Laryngology
JF - Annals of Otology, Rhinology and Laryngology
IS - 4
ER -