We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Special Feature |

Image of the Month FREE

Evan M. Renz, MC, USA; Theodore J. Kanne, MC, USA
[+] Author Affiliations

From the Department of Surgery, William Beaumont Army Medical Center, El Paso, Tex.

Section Editor: Grace S. Rozycki, MD

Arch Surg. 2001;136(11):1325-1326. doi:.
Text Size: A A A
Published online

If such a dreamy touch should fall, O turn thee round, resolve the doubt; My guardian angel will speak out In that high place, and tell thee all.—Alfred Lord Tennyson

A 13-MONTH-OLD boy was brought to the emergency department by his parents within 1 hour of an acute choking episode at home. He was suspected of having swallowed a small guardian angel pin now missing from his mother's clothing. The otherwise healthy child was crying, drooling, and appeared to be in mild discomfort. He demonstrated clear breath sounds bilaterally without wheezing or stridor. His oxygen saturation remained 98% on room air. Posteroanterior (Figure 1) and lateral radiographs were obtained.


A. Urgent endotracheal intubation in the emergency department

B. Retrieval of the foreign body using a Foley catheter with fluoroscopic guidance

C. Direct laryngoscopy, endotracheal intubation, and rigid esophagoscopy with foreign body removal in the operating room

D. Endoscopic removal of the object using intravenous sedation




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Radiographic and Anatomic LSS

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis