Talk:Foreign body aspiration

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 19 November 2018 and 14 December 2018. Further details are available on the course page. Student editor(s): Atl201. Peer reviewers: Smithdu92.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 21:23, 17 January 2022 (UTC)

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 19 October 2020 and 13 November 2020. Further details are available on the course page. Student editor(s): Logan6465. Peer reviewers: Mitchell.mcelroy.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 21:23, 17 January 2022 (UTC)

Fall 2018 Work Plan
I will be editing this article over the next month as part of a course for my medical school curriculum.

This article has much room for improvement considering there is limited information on this page thus far. I will work on the lead section to make sure this information is factual and informative to give the reader an overview about foreign body aspiration. My next starting point will be to create headings for different sections of the article such as Signs and Symptoms, Diagnosis, Treatment, Epidemiology, Complications, etc. I will start my search by looking for sources from reputable, published medical literature. The nature of this topic inherently involves special populations, so I will also focus on including information about children and the elderly while also providing information about foreign body aspiration in the healthy adult patient as well. I plan to add information about the anatomy of the human airway to provide a greater understanding to readers about foreign body aspiration and where it can occur in the human body. I can add images to this section to help the reader visualize the anatomy of the airway. I will also discuss the pathophysiology between a foreign object and the airway that leads to choking. In the signs and symptoms section of this article I will distinguish between the types of foreign body aspiration, and the signs and symptoms that distinguish the need for emergent intervention vs. less urgent cases. I will also discuss things that can mimic foreign body aspiration in patients.

I plan to expand upon the Causes section and talk about the most common things that cause foreign body aspiration in different age groups. This will include the most commonly aspirated objects for different demographics, as well as different factors that can lead to an increased risk of foreign body aspiration in a patient. I will add a section regarding diagnosis of foreign body aspiration. This will include physical exam techniques and imaging modalities that are best used for identifying a foreign body. I will include pictures of common imaging modalities used for this topic. I will also provide examples of imaging findings suggestive of foreign body aspiration. I will include supportive measures for patients presenting with this complaint, and the differences between managing this problem in the outpatient setting vs within a hospital setting. I will discuss prevention of foreign body aspiration, and also focus on safety measures for vulnerable populations. I will expand upon the existing Treatment section and how treatment differs for adults, children, and the elderly. I will also add a section about possible complications of foreign body aspiration. Within this section I will discuss the varying severity of foreign body aspiration. I will provide information regarding the outcomes related to this issue for different populations. I will also add information about follow-up treatment following foreign body aspiration.

Throughout these sections I will focus on how each topic relates to the different populations of patients I have mentioned. These are important factors when discussing preventative measures, outcomes, and treatment. I will do my best to use high quality, secondary sources about foreign body aspiration to contribute to this article. My search for sources will be primarily done through Access Medicine and Clinical Key. There is much literature regarding foreign body aspiration in adults and in pediatrics, so I hope to combine the existing knowledge in a clear and concise way in this article. I will embed links to other Wikipedia articles to direct readers who desire to learn more about a topic I discuss on this page. I will also do my best to avoid medical jargon and use plain language to best present this information to the general public. References: Pediatric Foreign Body Aspiration. Joshua D. Rovin, Bradley M. Rodgers. Pediatrics in Review Mar 2000, 21 (3) 86-90; DOI: 10.1542/pir.21-3-86 Bain, Alexandra et al. “Foreign-body aspiration in the adult: presentation and management” Canadian respiratory journal vol. 20,6 (2013): e98-9.

Atl201 (talk) 20:11, 19 November 2018 (UTC)

Peer Review
The article is very clear and concise. I think you did a wonderful job avoiding jargon where possible. I like how you used ample hyperlinks even for things that might seem simple. It allows different types of reader to understand the article even if they don’t have medical knowledge. This was especially of use in your diagnosis and treatment sections. I think it would be easy to get overly scientific in these sections. I felt that everything in the article was relevant to the topic and nothing really distracted me. One thing that I thought might be of use is arrows on the X-ray images. I feel people in the general public may get more out of those with something clearly identifying what the image is trying to display. Its minor and I know it can be difficult with the image restrictions Wikipedia has.

The article presents the information without expressing any opinions or trying to convince the reader of anything. There is nothing can be viewed as nonfactual or biased.

I liked how you cited after just about every sentence. I think this removes any doubt about the origin of any information within the article. All of the sources are recent and reliable. I believe most of these sources are not publically available but I believe that is to be expected with this type of topic.

One thought I had was if some info about the complications of some of the treatments options, such as rigid bronchoscopy, should be included. It may not be 100% relatable, and is probably in the hyperlink but was one of the things I found myself wondering about. Additionally, you might consider adding a hyperlink for the bilateral decubitus x-ray if one is available.

Overall, I thought the organization makes sense and your edits were well done.Smithdu92 (talk) 04:02, 10 December 2018 (UTC)

2020 Modifications- UCF College of Medicine Student Workplan
Over the next month I will be revising and adding on to this article. The most recent editor, Alt201, did a fantastic job improving this content in 2018!

Here are some thoughts on the current state of the article:
 * The lead section is a concise intro but does not include article highlights which could help strengthen this section. Also, the second sentence's wording could be improved to simplify the routes of airway obstruction.


 * 7 of the 8 sources (all of which are reliable) are books and therefore not easily accessible by the majority of the public. I even had trouble gaining access to these through my school's medical library. This makes verifying and/or clarifying the article info, as well as gaining further knowledge challenging for the reader. The one direct link to a source (eMedicine) is correct, but this website requires an account to be created in order to view the information, which may deter readers from venturing further into the only online source.


 * It is difficult to assess if all of the current sources are neutral or biased without reading the full text in addition to the section directly sourced. Sometimes book authors can be biased when writing about their field based on their own personal patient interactions and clinical outcomes. With the credentials of these authors and the fairly straightforward nature of this clinical presentation and subsequent management, I do not think biased sources will be an issue.


 * Overall structure is clear. Sections well-balanced with symptoms and treatments appropriately being the most detailed. Everything included is relevant and nothing is distracting in my opinion. There are no references to unnamed groups.


 * Coverage of the topic is neutral and has no biased claims that I can find.


 * There is brief mention of aspiration pneumonia in the symptoms section, but as this is a very prevalent problem especially in the growing elderly population today, I feel this could become it's own section to increase scope of this article.


 * In the diagnosis section, a brief explanation of why a negative chest xray cannot rule out this diagnosis is needed. The layman would not already know what materials show up on xrays so I think this could be better explained. When quickly trying to find a wikipage to link here to explain it, I could not find one that was simple enough at first glance to answer this question (ie the chest xray, xray, and echogenicity pages were very in depth scientifically but I could not find a clear section simply explaining what objects or materials show on xrays) so I think including a brief explanation here is appropriate.

I plan to work on the following over the next 3 weeks:

1. Review current sources in addition to adding verifiable, easily accessible secondary sources and images. I plan to utilize evidence-based medical databases to find resources such as PubMed, Clinical Key, UpToDate, Epocrates, etc to find additional sources giving preference to those which are more accessible to the general public. For images I will use Wikimedia Commons and other images with free licenses. I will also work to ensure no close para-phrasing from the books are in the article once access is granted.

2. Create or add to sections discussing prevention, more detailed epidemiology, pertinent anatomy and physiology, complications of aspiration v treatment, clarifying emergent v inpatient v outpatient treatment algorithms and options (with diagrams), conversation on aspiration in the elderly, and anything else that comes up in my research. I will do my best to avoid medical jargon. When included, I will make sure to explain the term and/or incorporate a link to further information.

3. Work to increase the number of imbedded links for page previews of medical terms in order to increase reader comprehension.

4. As diagnostic imaging can be challenging to interpret by the general public, I will include arrows and detailed descriptions in the included photos. The first image of a child with an aspirated peanut in the right bronchus is a great inclusion, but it currently has a higher level description than expected for the general public to decipher. The second image of a larynx is interesting but it is difficult to orient oneself and visualize the meat fragment the description mentions. The third image is my favorite as the aspirated object is easy to locate and it is straightforward to picture the airway obstruction with its location, even for the non-medical reader. There can still be more added to the description such as where the coin is sitting anatomically and what material it is. This will help connect this image to the paragraph discussing chest xrays in the diagnosis section.

5. Check for any out of date information to ensure information included in the article is the most recent and accepted.

I hope these edits allow this high-importance page to move up on the quality scale.

Please feel free to message me with any questions or concerns!

(Logan6465 (talk) 20:08, 21 October 2020 (UTC))

Peer Review
Opening section

Good, clear and concise opening paragraph. There is some medical jargon that may be be borderline: “trachea,” “bronchus,” “management,” “Clinical outcomes,” etc. These are most likely okay to leave in place in my opinion,

Audience

In my first pass, the article does read as if the intended audience is a medical student. It does require some knowledge of medical anatomy and procedures. There may be some places where it would be helpful to be more general. For example, you could say bronchus instead of “mainstem or lobar bronchus.” Because I like how it currently is, I wonder if it could benefit from an emergency section that explained the signs and symptoms in basic terms in a bulleted list.

Sources

Medscape (free login wall)

Textbook 2018

Meta analysis

Dynamed (pay wall?)

Open access Pediatrics committee report

Textbook 2017

Review

Open access Pediatrics review

Textbook 2019

Textbook 2009

Textbook 2015

Review Pediatric ENT

Annals of EM (free login wall)

UpToDate

Textbook 2015

All online links are working well.

Images:

The images used in this article are very helpful and impressive regarding pathology. The only thing I would add would be an indicator of the aspirated battery, corn, or even the atelectatic lobe. I understand editing these images can cause some copyright issues, and I do think the captions mitigate most confusion.

Additional suggestions:

In the diagnosis section, I think it would be helpful to separate the Physical examination and radiographic paragraphs with headers.

The management section could benefit from a wiki link to the BLS or ACLS page (if those exist).

In the complications section, it may be helpful to stick to using the word complications and avoiding synonyms like “outcomes” or “adverse outcome.”

It is possible that the management section is a little more detailed than it needs to be. Maybe reach out to the wiki community to see if that is something they agree with.

Link to words:

Rigid bronchoscopy

Flexible bronchoscopy

General anesthesia

Anti-inflammatories

“secretions” to airway secretions Mitchell.mcelroy (talk) 21:56, 10 November 2020 (UTC)

2020 Peer Review Response and Changes
User: Mitchell.mcelroy Thank you for taking the time to review the article to thoroughly! I appreciate your help in making this an even stronger page. Here are the changes I made based on your comments.

-Decreased medical jargon in all sections when possible. I liked your idea of minimizing to terms like "bronchus", and did just that.

-Added a small table with the major symptoms for acute and chronic aspiration for improved understanding of the major aspects of that section.

-Made sure the image descriptions were clear to non-medical readers. I think for now the descriptions are adequate, but arrows to the pathology would never hurt. I may look into the copyright guidelines and see if there are changes that can be made.

-Diagnosis section- separated physical exam and diagnostic imaging with section headers.

-Added links to BLS, ACLS, and choking first aid pages at the top of the management section.

-Complications section- changed all synonyms to "complication."

-I agree the management section seems like an outlier compared to the others. If others in the course or the wiki-community think it is unbalanced enough to warrant revisions I can decrease the level of detail currently included.

-Added links to the words you mentioned as well as others I found in my final read-through.

Again, thank you very much for your help! I hope this page will qualify for a higher level on the quality scale. I will put in a request for a review of the rating today.

Logan6465 (talk) 15:15, 11 November 2020 (UTC)