This is an x-ray of a 79 yo man who had lost weight and was being evaluated for swallowing difficulties. During the process of having him rapidly swallow barium (dense element that allows one to visualize structures), he aspirated the barium into his lungs. This led to respiratory failure.
The x-ray showed barium into both right and left main stem bronchi in the left upper and lower lobes. The barium spread to the smaller airways which produced the tree-in-bud appearance (arrow).
This patient had the barium suctioned out (as much as possible), but he developed shock, his heart stopped beating and he suffered severe brain injury. He died a short time later.
That’s one way to fail a barium swallow with flying colors…..
We just did an inservice on prevention of this type of thing a few weeks back.
(For any in the law enforcement community, do not worry, I will not be releasing any sensitive information. I would never want to aid someone committing a crime.)
The FBI along with ICE allowed a few of us in the EMS community to participate in a joint training on Hostage negotiation. During…
Repost. Why? There are so many people whining on my activity feed. Work on an ambulance for an extended number of years, breaking your back, in a 911 situation…..then get back to me. Only then will I acknowledge your whining. I’m sorry if you are fat and this offends you…but this reality. We don’t sugar coat reality. My back certainly didn’t sugar coat reality…and it hurts every damn day…and I still do the job. So STFU to the whiners.