A 20 year old male son of a doctor presented with #nasal bone for fixation. Or of ASA-I the procedure was completed with GA with atropin thiopentone scholine vecuron. Elevation of #pieces done with with an external application of plaster. A nasal pack was given to both nostrils individually. Tongue tie was applied to prevent fall of tongue and easy mouth breathing. Anesth was reversed and after satisfactory recovery , sent to ward. 15-20 mins later emergency call was given for the patient had difficulty in breathing and cyanosis.
The patient was attended within minutes .The pattern of respiration indicated acute airway obstruction with severe indrawing of chest wall. The pt was cyanotic and unresponsive. The patient was intubated on the ward bed. While trying to ventilate with an Ambu there was much resistance and not knowing what to do brought the patient to OT . Connected to anaesthesia machine but still not possible to ventilated. The pulse oxymeter could not show any pulse.. I could feel the patient has arrested and lying flaccid. The ET tube wasRemoved and tried to visualise what was in trachea. With flaccid and wide open glottic opening, I could see something whitish deep down the trachea. That object was beyond the reach of Maggils forceps. Fortunately a long foreign body forceps was available with that I could catch the whitish object. Lo it was one of the nasal pack.. (picture below). The father a doctor who was present in OT collapsed on the floor with vasovagal attack Pt was reintubated a few cardiac massage and a thump on the chest wall the heart activity returned and within 20 mins the patient regained full consciousness.Pt was treated for possible hypoxic brain injury. The patient recovered completely without any residual damage.
pICTURE OF FOREIGN BODY
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