Aspiration of shattered windshield glass after blind nasotracheal intubation in a motor vehicle crash

Chewing Gum in the Larynx: Foreign Body Aspiration or Iatrogenic Artifact? Challenges in Determining the Cause of Death in a Road Traffic Accident Victim With Resuscitation Intervention

Identifying the cause of death in road traffic incidents and the contributing factors is crucial for forensic investigations, public health research, and epidemiological studies. In this case, the discovery of chewing gum in the larynx during an autopsy complicated the forensic diagnostic process and challenged the determination of the primary cause of death. Our case report details a 53-year-old male driver involved in a fatal road traffic accident. First responders found him unconscious and unresponsive. Despite resuscitative efforts, including endotracheal intubation, he could not be revived. The autopsy revealed multiple blunt force injuries from the collision and chewing gum in the larynx. The gum may have been aspirated while driving, potentially causing choking, severe coughing, or reflex cardiac arrest, which could have led to sudden incapacitation and the accident. Alternatively, the gum might have been overlooked during intubation, possibly pushing it deeper into the airway and creating an iatrogenic artifact. The cause of death was attributed to multiple blunt force injuries, specifically head trauma. However, the possibility of foreign body aspiration leading to the accident or the gum being an iatrogenic artifact cannot be ruled out. This case report highlights the potential impact of airway foreign bodies on road accidents and the risk of iatrogenic artifacts during resuscitation. It underscores the importance of thorough airway evaluation, prompt recognition of potential obstructions, and accurate documentation in prehospital settings to prevent worsening obstructions, misdiagnoses, delays in diagnosis, and complications in future cases.

Extubation failure: Upper airway obstruction by chewing gum. A case report

Extubation failure can result from different complications, mostly well described in the literature such as laryngeal edema. Airway obstruction by foreign bodies is a less frequent and unexpected complication and its detection remains a challenge to healthcare professionals. In this case-report, we describe a patient admitted in an intensive care unit following a motor vehicle accident and who underwent an extubation failure and tracheostomy placement due to a misdiagnosed obstruction of a foreign body in the upper airway. Thus, screening of foreign bodies should be considered with a careful interpretation of medical imagery and clinical evaluation in these patients. Finally, cuff leak test, ultrasonography and videolaryngoscopy can be important adjuvants to the identification of suspected foreign bodies.

Acute respiratory failure following traumatic tooth aspiration

Foreign body aspiration can infrequently occur following trauma. Tooth aspiration after trauma is a rare clinical scenario. Here, we report a case in which tooth aspiration after trauma led to a presentation of acute respiratory failure with clinical findings mimicking tension pneumothorax. Successful removal of the aspirated tooth was accomplished by rigid bronchoscopy. Tooth aspiration must be considered in the list of differential diagnosis for any patient having signs or symptoms of respiratory distress following trauma especially maxillofacial trauma.

Aspiration of an oropharyngeal airway during nasotracheal intubation

The oropharyngeal airway (OPA) has been a remarkably safe device since its invention by Guedel in 1933. This plastic device is easily placed in the mouth and used for aiding in mask ventilation. We report a case of the aspiration of an OPA causing near total upper airway obstruction.