Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 Per haps lessons in chewing or an enema. ========================================= Challenge You respond to a residence where yu find a 60 y/o male who says that he has food stuck in his esophabus. His airway is not compromised. His only complint is that the food that he swallowed has " stuck " in his esoophagus and won't go down. What can you give him to alleviate this situation? GG Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 Per haps lessons in chewing or an enema. ========================================= Challenge You respond to a residence where yu find a 60 y/o male who says that he has food stuck in his esophabus. His airway is not compromised. His only complint is that the food that he swallowed has " stuck " in his esoophagus and won't go down. What can you give him to alleviate this situation? GG Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 Per haps lessons in chewing or an enema. ========================================= Challenge You respond to a residence where yu find a 60 y/o male who says that he has food stuck in his esophabus. His airway is not compromised. His only complint is that the food that he swallowed has " stuck " in his esoophagus and won't go down. What can you give him to alleviate this situation? GG Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 I would first say it would be best to try and see if the pt would be able to remove it himself. If that didn't work I would consider using Nitro in order to relax the esophagus. I wouldn't think that using nitro would work very well but its a shot. If that didn't work I would probly tell the pt its best that they go to the ER and let the ERP fish it out with a pair of magills. And I guess if that didn't work I would consult an Ear nose and throat doc to see what kind of procedure they could perform. And on the off chance that didn't work either... there's always hospice. -Txbasic > You respond to a residence where yu find a 60 y/o male who says that he has > food stuck in his esophabus. > > His airway is not compromised. His only complint is that the food that he > swallowed has " stuck " in his esoophagus and won't go down. > > What can you give him to alleviate this situation? > > > GG > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 I would first say it would be best to try and see if the pt would be able to remove it himself. If that didn't work I would consider using Nitro in order to relax the esophagus. I wouldn't think that using nitro would work very well but its a shot. If that didn't work I would probly tell the pt its best that they go to the ER and let the ERP fish it out with a pair of magills. And I guess if that didn't work I would consult an Ear nose and throat doc to see what kind of procedure they could perform. And on the off chance that didn't work either... there's always hospice. -Txbasic > You respond to a residence where yu find a 60 y/o male who says that he has > food stuck in his esophabus. > > His airway is not compromised. His only complint is that the food that he > swallowed has " stuck " in his esoophagus and won't go down. > > What can you give him to alleviate this situation? > > > GG > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 I would first say it would be best to try and see if the pt would be able to remove it himself. If that didn't work I would consider using Nitro in order to relax the esophagus. I wouldn't think that using nitro would work very well but its a shot. If that didn't work I would probly tell the pt its best that they go to the ER and let the ERP fish it out with a pair of magills. And I guess if that didn't work I would consult an Ear nose and throat doc to see what kind of procedure they could perform. And on the off chance that didn't work either... there's always hospice. -Txbasic > You respond to a residence where yu find a 60 y/o male who says that he has > food stuck in his esophabus. > > His airway is not compromised. His only complint is that the food that he > swallowed has " stuck " in his esoophagus and won't go down. > > What can you give him to alleviate this situation? > > > GG > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 glucagon =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-= J. Nile , EMT-P PharmD Candidate (May 2005) The University of Texas at Austin & The University of Texas Health Science Center at San E-mail: jnbarnes@... Phone: Pager: =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-= Challenge > You respond to a residence where yu find a 60 y/o male who says that he has > food stuck in his esophabus. > > His airway is not compromised. His only complint is that the food that he > swallowed has " stuck " in his esoophagus and won't go down. > > What can you give him to alleviate this situation? > > > GG > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 glucagon =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-= J. Nile , EMT-P PharmD Candidate (May 2005) The University of Texas at Austin & The University of Texas Health Science Center at San E-mail: jnbarnes@... Phone: Pager: =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-= Challenge > You respond to a residence where yu find a 60 y/o male who says that he has > food stuck in his esophabus. > > His airway is not compromised. His only complint is that the food that he > swallowed has " stuck " in his esoophagus and won't go down. > > What can you give him to alleviate this situation? > > > GG > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 glucagon =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-= J. Nile , EMT-P PharmD Candidate (May 2005) The University of Texas at Austin & The University of Texas Health Science Center at San E-mail: jnbarnes@... Phone: Pager: =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-= Challenge > You respond to a residence where yu find a 60 y/o male who says that he has > food stuck in his esophabus. > > His airway is not compromised. His only complint is that the food that he > swallowed has " stuck " in his esoophagus and won't go down. > > What can you give him to alleviate this situation? > > > GG > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 I've heard that before too... but I can't remember what the rationale behind it was. > glucagon > =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- =-=-=-= > J. Nile , EMT-P > PharmD Candidate (May 2005) > The University of Texas at Austin > & The University of Texas Health Science Center at San > E-mail: jnbarnes@m... > Phone: > Pager: > =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- =-=-=-= > Challenge > > > > You respond to a residence where yu find a 60 y/o male who says that he > has > > food stuck in his esophabus. > > > > His airway is not compromised. His only complint is that the food that > he > > swallowed has " stuck " in his esoophagus and won't go down. > > > > What can you give him to alleviate this situation? > > > > > > GG > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 I've heard that before too... but I can't remember what the rationale behind it was. > glucagon > =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- =-=-=-= > J. Nile , EMT-P > PharmD Candidate (May 2005) > The University of Texas at Austin > & The University of Texas Health Science Center at San > E-mail: jnbarnes@m... > Phone: > Pager: > =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- =-=-=-= > Challenge > > > > You respond to a residence where yu find a 60 y/o male who says that he > has > > food stuck in his esophabus. > > > > His airway is not compromised. His only complint is that the food that > he > > swallowed has " stuck " in his esoophagus and won't go down. > > > > What can you give him to alleviate this situation? > > > > > > GG > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 I've heard that before too... but I can't remember what the rationale behind it was. > glucagon > =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- =-=-=-= > J. Nile , EMT-P > PharmD Candidate (May 2005) > The University of Texas at Austin > & The University of Texas Health Science Center at San > E-mail: jnbarnes@m... > Phone: > Pager: > =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- =-=-=-= > Challenge > > > > You respond to a residence where yu find a 60 y/o male who says that he > has > > food stuck in his esophabus. > > > > His airway is not compromised. His only complint is that the food that > he > > swallowed has " stuck " in his esoophagus and won't go down. > > > > What can you give him to alleviate this situation? > > > > > > GG > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 My first though was viscous lidocaine. It is probably unlikely that he really has food stuck in his esophagus. A careful history would help point you in the right direction, but my first guess would be that this is probably a globus sensation he is experiencing- possibly aggravated because of the stretching of the smooth muscles, but probably due at least in part to a more chronic condition such as GERD. I would focus on the alleviation of this gentleman's discomfort rather than attempting to discern the underlying pathology and treat according to whether I really thought he had a fish bone stuck in his esophagus. Glucagon would relax the smooth muscles and inhibit peristalsis. Hopefully, it would allow the food to pass, but there might not be any food to pass. Since this gentleman is fully conscious and his protective reflexes are intact, I would try a less invasive approach first. My question is: what are the implications of administering either of these therapies if the underlying condition is really Boerhaave syndrome? - Challenge You respond to a residence where yu find a 60 y/o male who says that he has food stuck in his esophabus. His airway is not compromised. His only complint is that the food that he swallowed has " stuck " in his esoophagus and won't go down. What can you give him to alleviate this situation? GG Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 My first though was viscous lidocaine. It is probably unlikely that he really has food stuck in his esophagus. A careful history would help point you in the right direction, but my first guess would be that this is probably a globus sensation he is experiencing- possibly aggravated because of the stretching of the smooth muscles, but probably due at least in part to a more chronic condition such as GERD. I would focus on the alleviation of this gentleman's discomfort rather than attempting to discern the underlying pathology and treat according to whether I really thought he had a fish bone stuck in his esophagus. Glucagon would relax the smooth muscles and inhibit peristalsis. Hopefully, it would allow the food to pass, but there might not be any food to pass. Since this gentleman is fully conscious and his protective reflexes are intact, I would try a less invasive approach first. My question is: what are the implications of administering either of these therapies if the underlying condition is really Boerhaave syndrome? - Challenge You respond to a residence where yu find a 60 y/o male who says that he has food stuck in his esophabus. His airway is not compromised. His only complint is that the food that he swallowed has " stuck " in his esoophagus and won't go down. What can you give him to alleviate this situation? GG Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 My first though was viscous lidocaine. It is probably unlikely that he really has food stuck in his esophagus. A careful history would help point you in the right direction, but my first guess would be that this is probably a globus sensation he is experiencing- possibly aggravated because of the stretching of the smooth muscles, but probably due at least in part to a more chronic condition such as GERD. I would focus on the alleviation of this gentleman's discomfort rather than attempting to discern the underlying pathology and treat according to whether I really thought he had a fish bone stuck in his esophagus. Glucagon would relax the smooth muscles and inhibit peristalsis. Hopefully, it would allow the food to pass, but there might not be any food to pass. Since this gentleman is fully conscious and his protective reflexes are intact, I would try a less invasive approach first. My question is: what are the implications of administering either of these therapies if the underlying condition is really Boerhaave syndrome? - Challenge You respond to a residence where yu find a 60 y/o male who says that he has food stuck in his esophabus. His airway is not compromised. His only complint is that the food that he swallowed has " stuck " in his esoophagus and won't go down. What can you give him to alleviate this situation? GG Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 Glucagon..... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 Glucagon..... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 Glucagon..... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 I remember a call like this one many years ago. The pateint was talking, so he had an airwway. His vitals were fine. I put him on oxygen " just to help " and transported him in a position of comfort. When we got to the hospital the doctor gave him a teaspoon of Adolph's Meat Tenderizer mixed with water and had him follow it with more water after several minutes since the meat tenderizer would damage the esophagus if left alone for too long. Sounds strange but this was the treatment of choice back in the seventies in rural Mississippi. True Story. Ed Brando Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 I remember a call like this one many years ago. The pateint was talking, so he had an airwway. His vitals were fine. I put him on oxygen " just to help " and transported him in a position of comfort. When we got to the hospital the doctor gave him a teaspoon of Adolph's Meat Tenderizer mixed with water and had him follow it with more water after several minutes since the meat tenderizer would damage the esophagus if left alone for too long. Sounds strange but this was the treatment of choice back in the seventies in rural Mississippi. True Story. Ed Brando Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 I remember a call like this one many years ago. The pateint was talking, so he had an airwway. His vitals were fine. I put him on oxygen " just to help " and transported him in a position of comfort. When we got to the hospital the doctor gave him a teaspoon of Adolph's Meat Tenderizer mixed with water and had him follow it with more water after several minutes since the meat tenderizer would damage the esophagus if left alone for too long. Sounds strange but this was the treatment of choice back in the seventies in rural Mississippi. True Story. Ed Brando Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 Nile, I was going with NTG, but thanks for putting the stuff about glucagon on. It's certainly a possibility. I learned about it from a gastroenterologist who said she tried NTG first, and then if that didn't work, she would go to glucagon or something else. I recommended NTG just because of the ease of administration. Glucagon will certainly work. GG In a message dated 9/12/2004 9:28:50 PM Central Daylight Time, jnbarnes@... writes: Gene, while I am not sure glucagon is where you are going, here are a couple of references from PubMed. Nile http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abst ract & list_uids=14745641 Dysphagia. 2004 Winter;19(1):18-21. Assessment of the predictors of response to glucagon in the setting of acute esophageal food bolus impaction. Sodeman TC, Harewood GC, Baron TH. Department of Medicine, Division of Gastroenterology, Mayo Medical Center, Rochester, Minnesota, USA. Esophageal food impactions are frequently seen in endoscopic practice. Glucagon is known to relax the lower esophageal sphincter and has been used with variable success to treat food impactions. We retrieved clinical information of all patients with acute food impactions who attended the emergency room from 1975 to 2000 from the Mayo diagnostic database. Data were abstracted on age, sex, body mass index, relevant prior medical history, food type ingested (meat, bread, vegetable, or other), duration of symptoms at presentation, dosage (in mg) of glucagon, outcome including success of glucagon or spontaneous passage, and endoscopic findings. A total of 222 cases of food impaction were identified, of whom 106 patients (48%) received glucagon, average 1 mg. In glucagon responders, meat was less likely to be the offending food type, accounting for 70% (glucagon responders) vs. 90% (in nonresponders) ( p = 0.03), while responders were less likely to have esophageal rings/strictures detected on subsequent EGD compared with nonresponders, 0% (glucagon responders) vs. 31% (nonresponders) ( p = 0.05). In the patients that did not receive glucagon, spontaneous resolvers had a shorter duration of symptoms at presentation, 3.3 h vs. 12.4 h ( p = 0.07) and were less likely to have an organic esophageal obstruction detected on EGD, 0% vs. 21%. There were no significant differences between the resolvers and nonresolvers in terms of age, gender, BMI, and prior medical history. Conservative management of acute food bolus obstruction, either with or without glucagon, is most successful in the absence of a fixed esophageal obstruction. An impacted meat bolus is more likely to require intervention for removal than other food types. These clinical predictors should be considered before administration of glucagon. ht tp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & dopt=Abstract\ & list_uids=9828271 Dysphagia. 1999 Winter;14(1):27-30. Effect of doses of glucagon used to treat food impaction on esophageal motor function of normal subjects. Colon V, Grade A, Pulliam G, C, Fass R. Department of Medicine, Section of Gastroenterology, Tucson VA Medical Center, Tuscon, Arizona 85723, USA. We studied 10 normal subjects to determine the effect of doses of intravenous glucagon used to treat food impaction on esophageal motor function. With a multilumen assembly perfused by a low compliance pneumohydraulic infusion pump, esophageal manometry was performed during baseline and after randomized administration of 0. 25, 0.5, and 1 mg intravenous glucagon. Mean proximal and distal amplitudes of contraction, proximal and distal amplitude of contraction duration, lower esophageal sphincter (LES) resting pressure, percentage of LES relaxation, and glucagon-related side effects were evaluated. No effect on proximal amplitude of contraction and proximal or distal esophageal contraction duration was noted. Mean amplitude of contraction in the distal esophagus was further reduced with increased dosage of glucagon but did not achieve statistical significance. Mean LES resting pressure was significantly reduced after 0.25 mg (18.7 +/- 1.8 vs. 10.2 +/- 1.5 mmHg, p = 0.0001) and further reduced after 0.5 mg (5.9 +/- 1.2 mmHg, p = 0.0009). Mean LES relaxation was significantly reduced after 0. 25 mg (93.1 +/- 2.4% vs. 63.6 +/- 8.8%, p = 0.0031). The 1-mg dose versus the 0.5-mg did not provide further reduction in any LES function parameters. One subject experienced transient nausea after 0.5 mg, and 4 subjects experienced nausea after 1 mg glucagon. In conclusion, increased doses of glucagon further reduce mean distal esophageal amplitude of contraction. Although maximum reduction in mean LES resting pressure was achieved with 0.5 mg, it did not provide any potential therapeutic advantage over 0.25 mg glucagon. Nausea is a common, transient side effect predominantly affecting subjects treated with the 1-mg dose. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & dopt=Abst ract & list_uids=11157302 Acad Emerg Med. 2001 Feb;8(2):200-3. Glucagon use for esophageal coin dislodgment in children: a prospective, double-blind, placebo-controlled trial. Mehta D, Attia M, Quintana E, Cronan K. Department of Pediatrics, Alfred I. duPont Hospital for Children, Wilmington DE, USA. OBJECTIVE: Prospective evaluation of the use of glucagon in dislodgment of impacted esophageal coins in children. METHODS: This was a double-blind, placebo-controlled study with an open-label second phase in children 1 to 8 years of age who presented to a pediatric emergency department with a radiographically confirmed single esophageal coin impaction. One milligram of glucagon or placebo was given intravenously in double-blinded fashion. Patients were placed in an upright position and asked to drink 2-3 ounces of water. A repeat radiograph was obtained to check coin position in 30-60 minutes. Patients who did not respond were given 1 mg of open-label glucagon intravenously. The glucagon and placebo groups were compared. RESULTS: Fourteen patients were enrolled in the study (the predetermined sample size was not pursued due to inefficacy). Nine patients were in the glucagon group, and five were in the placebo group. Six patients received an additional open-label glucagon dose. The two groups were not different in age (mean, 5.5 years and 4.5 years, respectively), coin position, time between ingestion and presentation (p = 0.45), or time between treatment and repeat radiograph (p = 0.29). In patients who received glucagon, two of 15 (15%) passed the coin into the stomach. In the placebo group, three of five (60%) passed the coin, an inversely significant ratio. Five of six patients who received open-label glucagon were from the initial glucagon group. There were no responders among patients in this group. CONCLUSIONS: Glucagon does not appear to be effective in the dislodgment of esophageal coins in children. =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-= J. Nile , EMT-P (LP) PharmD Candidate (May 2005) The University of Texas at Austin & The University of Texas Health Science Center at San E-mail: jnbarnes@... Phone: Pager: =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-= ----- Original Message ----- To: < > Sent: Sunday, September 12, 2004 1:37 AM Subject: Challenge > You respond to a residence where yu find a 60 y/o male who says that he has > food stuck in his esophabus. > > His airway is not compromised. His only complint is that the food that he > swallowed has " stuck " in his esoophagus and won't go down. > > What can you give him to alleviate this situation? > > > GG > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 I had a call exactly like that. He was drooling, couldn't swallow and said he felt something there. He wanted me to try and get it out. So out came the magills and laryngescope, of course he gagged. I put him on O2 3 LPM nasal cannula, put a saline lock in him, cardiac monitor and took him to the hospital. I figured he had earned himself an endoscopy. Still thinking about it, I figured maybe a steroid (solumedrol) for the swelling, valium for relaxation, or terbutaline for smooth muscle relaxation > You respond to a residence where yu find a 60 y/o male who says that he has > food stuck in his esophabus. > > His airway is not compromised. His only complint is that the food that he > swallowed has " stuck " in his esoophagus and won't go down. > > What can you give him to alleviate this situation? > > > GG > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 I had a call exactly like that. He was drooling, couldn't swallow and said he felt something there. He wanted me to try and get it out. So out came the magills and laryngescope, of course he gagged. I put him on O2 3 LPM nasal cannula, put a saline lock in him, cardiac monitor and took him to the hospital. I figured he had earned himself an endoscopy. Still thinking about it, I figured maybe a steroid (solumedrol) for the swelling, valium for relaxation, or terbutaline for smooth muscle relaxation > You respond to a residence where yu find a 60 y/o male who says that he has > food stuck in his esophabus. > > His airway is not compromised. His only complint is that the food that he > swallowed has " stuck " in his esoophagus and won't go down. > > What can you give him to alleviate this situation? > > > GG > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 12, 2004 Report Share Posted September 12, 2004 I had a call exactly like that. He was drooling, couldn't swallow and said he felt something there. He wanted me to try and get it out. So out came the magills and laryngescope, of course he gagged. I put him on O2 3 LPM nasal cannula, put a saline lock in him, cardiac monitor and took him to the hospital. I figured he had earned himself an endoscopy. Still thinking about it, I figured maybe a steroid (solumedrol) for the swelling, valium for relaxation, or terbutaline for smooth muscle relaxation > You respond to a residence where yu find a 60 y/o male who says that he has > food stuck in his esophabus. > > His airway is not compromised. His only complint is that the food that he > swallowed has " stuck " in his esoophagus and won't go down. > > What can you give him to alleviate this situation? > > > GG > > > > Quote Link to comment Share on other sites More sharing options...
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