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Pediatric Emergencies in the Time of COVID-19

A recent Sunday, while I was working a shift in the emergency room, an infant with Down syndrome arrived. The mother believed the child swallowed a plastic toy. When the patient arrived, the child was actively choking, gasping for air and fighting to maintain a partially obstructed airway.

Our team immediately jumped into action. We could barely glimpse a bright red piece of plastic in the patient’s posterior oropharynx that almost completely obstructed the airway. Taking the tools readily at hand, a needle holder from a nearby suture tray and a tongue blade, we were able to grasp the barely visible edge of the plastic piece and remove it from the airway.

It turns out the child swallowed a plastic pen cap that would have completely obstructed the airway if it had traveled further down the throat and lodged itself in the trachea or larynx.

The patient was given decadron, had a soft tissue lateral neck radiograph and was monitored for further airway damage or obstructions. Luckily, the child was able to drink and had no airway problems after monitoring. We sent the patient home in good health to the extreme relief and gratitude of the patient’s mother.

I know as a pediatric emergency physician that any day can turn into a mother’s worst nightmare. A pen cap, Lego or piece of food can turn deadly, regardless of coronavirus.

Our department has seen a rise in critical cases since COVID-19, but we are still here to serve the children of our community. My pediatric emergency colleagues and I have a heightened sense of duty during this time to continue to be here and ensure every child gets the best medical care during this time.