Wednesday, January 27, 2010

LIVING FOREIGN BODY IN FLOW METER

30 yr old ASA I patient was scheduled for lipoma excision. Anaesthesia was induced with propofol, fentanyl  and oxygen mask with nitrous oxide and sevoflurane. A classic LMA was introduced subsequently with IPPV by hand as the patient remained apneic.Desaturation  and high airway pressure followed by difficulty in ventilation . The LMA was removed and mask ventilation commenced which rectified the problem. Again on reinsertion of the same LMA resulted in difficulty of ventilation  and absent ETCO2 tracings.A proseal LMA was then inserted  and anaesthesia went uneventful. On careful examination of the lumen of the classic LMA revealed an impacted living foreign body, a beetle which might have crawled in, the prepared LMA from the induction room

COCKROACHES, SPIDERS AND CENTIPEDES BEING THE COMMON LIVING CREATURES FOUND IN ANAESTHESIA CIRCUITS.   EVENTHOUGH IT IS COMMON THAT  LIVING FOREIGN BODIES CAN ENTER INTO ANAESTHESIA CIRCUITS, IT IS QUITE UNCOMMON TO FIND THEM IN ANAESTHESIA MACHINE.WATCH THIS INTERESTING PHOTOGRAPH WHERE  YOU CAN  SEE A LIVING  FOREIGN BODY IN  FOW METER
                                             ROUTINE CHECK FOR ANAESTHETIC BREATHING SYSTEMS  IS MANDATORY BEFORE  INDUCING ANAESTHESIA AS THESE  LIVING FOREIGN BODIES CAN BE AN UNCOMMON CAUSE FOR BREATHING CIRCUIT OCCLUSION, AND THEREBY CAUSING HYPOXIA  AND SOMETIMES MAKE YOU THINK OF THE POSSIBILITY OF SEVERE BRONCHOSPASM OR PNEUMOTHORAX  IN VIEW OF HIGH AIRWAY PRESSURE AND RAPID DESATURATION .
CHECK OUT THE FOLLOWING LINK FOR  A REPORTED CASE  OF  OBSTRUCTION OF LMA BY A LIVING FOREIGN BODY,A NEMATODE FROM PATIENT'S OWN INTESTINE DURING ANAESTHESIA