Main Theme: Airway
Introduction
Inhaled foreign body (IFB) is a serious condition for which bronchoscopy is the diagnostic and therapeutic gold standard. Queensland Children’s Hospital (QCH) is the tertiary referral service for paediatric bronchoscopy in Queensland, an area seven times larger than the United Kingdom. We describe the methods of retrieval to QCH and compare patients retrieved with those presenting locally.
Methods
We conducted a retrospective cohort study at QCH. Children with suspected IFB from January 2018- December 2024 were included. Data analysed included mode and timeline of retrieval, clinical features, and complications.
Results
345 children underwent bronchoscopy with median age of 19 months (IQR 13–33); 167 (48.4%) had IFB found. 190 (55%) children were retrieved from other centres. 100 (53%) retrieved patients had IFB, compared to 66 (43%) non-retrieved. Retrieval modes were ambulance (122), private car (21), aeroplane (26) or helicopter (13). Children were retrieved from small rural and remote hospitals; regional and metropolitan non-tertiary centres; 12 (6%) were transferred interstate. Mean time from presentation to arrival at QCH was 12.4 hours. On arrival at QCH, 90% of patients’ X-Ray findings had changed from earlier imaging. During follow up, 4 (3%) non-retrieved patients developed Bronchiectasis, compared to 2 (1%) retrieved patients. There were no mortalities in the retrieval group.
Conclusion
Retrieving paediatric patients with IFB to a tertiary centre that covers a large geographical area is complex. Reviewing the retrieval pathway and patients’ clinical features gives opportunity to evaluate this process.