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2012 New Zealand

IMAGING THE PAEDIATRIC AIRWAY. 2012 New Zealand. CHILD. ADULT. CHILD. ADULT. BUTTON BATTERIES and COINS. 21 Month old swallowed watch battery (10.30am). Oesophageal mucosa burn 12 noon. SORE THROAT ? TONSILITIS.

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2012 New Zealand

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  1. IMAGING THEPAEDIATRICAIRWAY 2012 New Zealand

  2. CHILD ADULT

  3. CHILD ADULT

  4. BUTTON BATTERIES and COINS

  5. 21 Month old swallowed watch battery (10.30am) Oesophageal mucosa burn 12 noon

  6. SORE THROAT ? TONSILITIS

  7. SORE THROAT ? TONSILITIS DROOLING, CHOKING? FOREIGN BODY

  8. Stylohyoid ligament calcification

  9. SORE THROAT ? TONSILITIS DROOLING, CHOKING? FOREIGN BODY NECK SWELLING ? RETROPHARYNGEAL ABCESS

  10. SORE THROAT ? TONSILITIS DROOLING, CHOKING? FOREIGN BODY NECK SWELLING ? RETROPHARYNGEAL ABCESS BARKING COUGH, “HOOP” ? CROUP

  11. SORE THROAT ? TONSILITIS DROOLING, CHOKING? FOREIGN BODY NECK SWELLING ? RETROPHARYNGEAL ABCESS BARKING COUGH, “HOOP” ? CROUP STRIDOR ? EPIGLOTITIS

  12. EPIGLOTITIS

  13. ? RETROPHARYNGEAL ABCESS SUPINE NECK EXTENDED

  14. Pseudosubluxation PSEUDO SUBLUXATION PSEUDO Dictionary definition 1. False not genuine 2. Resembling or Imitating Appearance of subluxation Created artificially Mater Children’s Hospital

  15. SWISCHUCK LINE Posterior cervical line drawn Posterior arch of C1 to Posterior arch of C3 Should pass through or be less than 1mm anterior to posterior arch of C2 Spino-Laminar line Mater Children’s Hospital

  16. Pseudosubluxation True subluxation Mater Children’s Hospital

  17. Article from Neurosurgery March 2002 MANAGEMENT OF THE PAEDIATRIC CERVICAL SPINE AND SPINE CORD INJURY Conclusion Thoracic elevation or occipital recess to prevent flexion of the head and neck when restrained supine on flat board allows better neutral alignment in children younger than 8 years.

  18. CORRECT NECK FLEXION SHOULD PRODUCE NEUTRAL POSITION

  19. MATER RADIOLOGY QUEST Produce the most effective “TED” Thoracic elevation Device Study by Nypaver & Treloar1994 Evaluated 40 children younger than 8 years Assessed their neutral position on backboard All 40 required elevation of torso to eliminate neck flexion Mean amount of elevation required was 25mm

  20. Mater TED Dimensions 30mm high 20cms wide Placed under shoulders at level of acromioclavicular ligament

  21. CONCLUSION ELEVATION EXTEND THE NECK Mater Children’s Hospital

  22. GRATEFUL THANKS Dr Tony Lamont Dr Gill Long Adam Lack for photography Gerard Duckworth for photography Ivan Simic & my son Crawford for computer skills Olivia & Madonna, Jordan & Sally for modeling Kate Bilby for speech pathology assistance Vic Summers for his image suggestion Yourselves for listening

  23. REFERENCES AND TEXTS Pediatric Videofluoroscopy Studies Joan C. Arvendson Maureen A. Lefton-Greif Atlas of Human Body Professor Peter Abrahams Eyewitness visual dictionary of human body Covent Garden Books Internet article Bobby R. Alford Dept. of Otorhinolaryngology Atlas of Human Anatomy Frank H. Netter

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