I got a frantic call from my wife today morning.
She was on her way to the hospital in the Hospital’s ambulance with our maid’s eight-month old baby boy. She wanted me to get the Pediatrician to the Casualty. Our house is less than half a kilometre from the hospital, so they arrived at the Casualty in a few minutes.
The baby was breathing very fast (tachypneic) and was drowsy. His pulse rate was very high (126 beats per minute) and his oxygen saturation was very low (30%).
The Paediatrician did a rapid exam and found that there were no breath sounds heard over the left side of the chest. He asked for a stat chest radiograph.
The chest radiograph showed a completely collapsed left lung with compensatory hyperinflation of the right lung.
The kid had a foreign object obstructing the left main bronchus.
We called for the ENT surgeon. He arrived as the baby was being shifted to the operation theatre. He used a rigid bronchoscopy to inspect the airways and found a small Bengal gram stuck in the left main bronchus. He removed it and withdrew the scope. The baby’s oxygen saturation showed an immediate improvement and there was adequate air entry into the left lung. The baby was intubated and put on a ventilator till he recovered from the sedation.
A post procedure check radiograph taken about an hour later showed normal lungs on both sides.
The Bengal gram broke into little pieces after it was taken out. Here are the remains…
The baby woke up from the sedation about 2 hours later. The endotracheal tube was removed about 2 hours ago and he is doing well.
Now for the best part….
How did this happen?
Well the mother fed the baby (remember he’s eight-months old), a masala vadai. Wow!
UPDATE:
Mrs. Scan man saw this and was not very pleased. She felt that her role in the drama had not been accurately depicted. I agreed, apologised and updated the story.
Some of you know she is a doctor. She very recently obtained her postgraduate degree in Family Medicine.
Though she did not do a physical examination of the baby when he was brought to our house, she correctly suspected the possibility of foreign body aspiration. Hence her frantic call for the ambulance and to me.
My role in this was purely limited to the x-rays and the blogging 
P.S. I think I’ll get my dinner now.
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Scan Man: An excellent post bringing out the essentials of how medical doctors are invaluable to the well being of a society.
Congrats to Mrs. Scan Man and you and all the doctors involved, for saving the child.
Thank you Arunn for the kind words here and in the related post in your blog.
Good catch!
Thanks to the Mrs. for being on her toes!
Glad the little fella is doing ok.
I bet Mom is very relieved too.
I always had a fear of a foreign body aspiration in my kids when they were little.
I’m so glad everyone is ok now.
I guess that makes you guys heroes!!
Wow!
later…
Nicely exciting with some uncertainty and a happy outcome - who could ask for anything more. Except for the X-rays which were very helpful.
Is it wrong to have been momentarily diverted by the scrummy looking masala vadai?
Regards - Shinga
Great post, Vijay! Quick thinking on Dr. P’s part. As a kid I had a track record for stuffing things up my nose (peanuts, popcorn). Thankfully, they never made it to the bronchus.
I recently had an episode with my daughter (7) putting a stone in her ear and it having to be removed under sedation (sigh…), I can understand the traumatic experience this must have been. However, at least my daughter wasn’t in as much danger as this poor little love!
There are, however, 2 things about this post that make me chuckle: 1) What did you have to change in the original post that displeased Mrs Scanman? and 2) Dinner? Mrs Scanman stopped your dinner? Ah, cook takes instruction from the Mrs does she? So your powers as Un Scanman Extraordinaire do not prevail in the feeding stakes then …