title: Foreign body aspiration in adults and in children: advantages and consequences of a dedicated protocol in our 30-year experience.
abstract: BACKGROUND
  Foreign body (FB) inhalation is a potentially life-threatening emergency also in clinically stable patients as the situation could worsen at any moment. There is varying opinion regarding the urgency for removal of inhaled FBs, and there are no guidelines in the literature. The aim of our study was to present our experience with FB aspiration in children and adults from 1993, when we introduced our Thoracic Endoscopy Service with the availability "on call" of a bronchologist 24 hours a day, 7 days a week, defining a dedicated protocol together with our anaesthesiologists for prompt intervention in this situation.
  
  
  METHODS
  We consulted our database and examined the records of all patients undergoing bronchoscopy for suspected FB aspiration from 1993 onwards; our previous experience of 11 children and 14 adults with FBs from 1981 to 1992 was also included to compare the results obtained.
  
  
  RESULTS
  In this period, we removed 159 FBs (in 70 children and 89 adults) and performed 23 negative bronchoscopies in children and 6 in adults for suspected aspiration. All FBs were removed successfully. We were able to intervene immediately also in critical situations: in 60/70 children within 24 hours of admission to hospital, in 44 of these 60 on the actual day of admission, thus avoiding a potentially dangerous delay between aspiration and removal. We had no complications, and no patients needed surgery.
  
  
  CONCLUSIONS
  We conclude that an efficient organization involving a dedicated protocol of intervention, trained staff available 24 hours a day, 7 days a week, appropriate setting, and the right instrumentation enabled us to tackle this important emergency.
authors.affiliation: *Unità Operativa di Pneumologia e Endoscopia Toracica ‡Clinica Pediatrica della Facoltà di Medicina e Chirurgia, Università degli Studi di Parma §Servizio di Anestesia e Rianimazione dell', Azienda Ospedaliero-Universitaria di Parma, Parma, Italy †Unità Operativa di Fisiopatologia Respiratoria e UTIR, Azienda Ospedaliero-Universitaria di Parma.
authors.forename: Angelo G
authors.initials: AG
authors.lastname: Casalini
authors.forename: Maria
authors.initials: M
authors.lastname: Majori
authors.forename: Miriam
authors.initials: M
authors.lastname: Anghinolfi
authors.forename: Emanuela
authors.initials: E
authors.lastname: Burlone
authors.forename: Raffaele
authors.initials: R
authors.lastname: D'Ippolito
authors.forename: Marco
authors.initials: M
authors.lastname: Toschi
authors.forename: Giovanna
authors.initials: G
authors.lastname: Pisi
authors.forename: Daniele
authors.initials: D
authors.lastname: Barantani
authors.forename: Davoud
authors.initials: D
authors.lastname: Ghasempour
authors.forename: Maurizio
authors.initials: M
authors.lastname: Monica
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D001999:Bronchoscopy / Q000379:methods / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence / Q000592:standards; D019091:Critical Pathways; D057210:Delayed Diagnosis / Q000009:adverse effects; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D005188:False Negative Reactions; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D006760:Hospitalization / Q000639:trends; D006801:Humans; D007223:Infant; D001239:Inhalation; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D061665:Time-to-Treatment; D055815:Young Adult