Survival After Asphyxia Secondary to Gravel Aspiration

Impairment of adequate ventilatory exchange following pulmonary aspiration occurs secondary to a chemical burn to the tracheobronchial tree, mechanical obstruction with lodgement of particulate material in the glottis and below, or laryngospasm. The following case of sand and gravel aspiration is reported both to present a roentgenographic finding not previously described in the literature and to illustrate how normal survival without sequelae is possible even after a level of acidemia never before associated with full recovery.

PATIENT SUMMARY  A 12-year-old boy was admitted to the hospital in an agitated, semiconscious state after being completely buried in a sand and gravel pile at a construction site for at least four minutes. In the emergency room, he was cyanotic and in severe respiratory distress, with intercostal retractions, a blood pressure of 130/90 mm Hg, and a regular pulse of 108 beats per minute. Arterial blood gases drawn on 8 liters of oxygen