Spring In Mouth

A 2-year-old male is brought into the emergency department by his grandmother for noisy breathing. The grandmother reports that the child was unsupervised in the other room “for only seconds” when she began to hear crying and then noisy breathing. Before the event, the child had been doing well, meeting all developmental milestones, and thriving with his family. The examination of the mouth with the Wispr Digital Otoscope reveals this image.

The child has a metal spring in his posterior pharynx.

Although the child was breathing noisily, his airway was patent and his oxygen saturation was normal. Because of this, removal was urgent, but not emergent. It was unknown how deeply the spring was embedded in the soft tissues of the throat, and there was concern that removing the spring could lead to trauma and a potential airway disaster. For this reason, otolaryngology (ENT) was consulted. ENT removed the spring uneventfully in the emergency department with forceps. No sedation was required.

Although the Wispr Digital Otoscope is optimized for visualization of the anatomy of the ear canal, it can be a useful tool in both the mouth and nose.

Key Learning Points:

1. Pediatric airways are small and susceptible to blockage from foreign bodies or infection.
2. Don’t turn an urgent situation into an emergent situation. Get the right expertise involved.