Abstract
The patient was a ten-year-old boy who was buried under pebbly soil and suffered from marked airway obstruction.
He was transferred from a docter by an ambulance with oxygen inhalation. On arrival, he was nearly apneic and unconscious. Arterial blood gas analysis revealed pH 6.581, PaO2 400.2Torr, PaCO2 162.0Torr. Tracheotomy was done and most foreign bodies had been removed under bronchoscopy and by airway washing. Nine hours after removal, his consciousness was recovered. The pebbles in the right subsegmental bronchus B8b were removed using bronchofiberscope later on. The tracheal stoma was obliterated four days later. He was discharged from the hospital after fifteen days' stay without any complications, e. g., pneumonia, emphysema, tetanus nor sequelae.
Foreign bodies, in this case, were mixture of soil and pebbles of various sizes, and were removed effectively by different maneuver, i. e., soil by airway washing, pebbles in bronchi by bronchoscopy and pebbles in peripheral bronchus by bronchofiberscopy. Needle insertion into the airway through cricothyroid membrane seemed to be of crucial efficacy for the initial respiratory resuscitation.
