Cgabryszek: Created page with "Objective: * To attempt to resolve a Food Bolus Impaction via esophageal smooth muscle relaxation. * If glucagon administration is not successful at dislodging the Food Bolus, it will still expedite patient care by exhausting non-invasive management options. Notes: * This protocol should only be used for FOOD bolus impactions – DO NOT use for potentially rigid or sharp esophageal foreign bodies. * An esophageal food bolus impaction is a bolus of food/non-liquid that..."

2025-05-07T21:13:29Z

Created page with "Objective: * To attempt to resolve a Food Bolus Impaction via esophageal smooth muscle relaxation. * If glucagon administration is not successful at dislodging the Food Bolus, it will still expedite patient care by exhausting non-invasive management options. Notes: * This protocol should only be used for FOOD bolus impactions – DO NOT use for potentially rigid or sharp esophageal foreign bodies. * An esophageal food bolus impaction is a bolus of food/non-liquid that..."

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Objective:

* To attempt to resolve a Food Bolus Impaction via esophageal smooth muscle relaxation.
* If glucagon administration is not successful at dislodging the Food Bolus, it will still expedite patient care by exhausting non-invasive management options.

Notes:

* This protocol should only be used for FOOD bolus impactions – DO NOT use for potentially rigid or sharp esophageal foreign bodies.
* An esophageal food bolus impaction is a bolus of food/non-liquid that was incompletely swallowed and is obstructing the esophagus, but is not compromising the airway.
* Glucagon is a smooth muscle relaxer, with between 10% - 40% effectiveness (depending on the study being quoted) at facilitating clearance of esophageal food bolus impactions.
* For patients < 18 years old, contact medical control for management recommendations.

{| class="wikitable"
|'''EMR/EMT - Emergency Medical Responder'''
|}

# Provide routine medical care as indicated.
# '''Oxygen – High Flow''', assist with ventilations as indicated.
# Treat for signs and symptoms of respiratory distress as indicated.

{| class="wikitable"
|EMT- Emergency Medical Technician ''perform/confirm all above interventions''
|}

# Assure ALS intercept is en route.
# Apply ECG monitor & run strip (if trained, if time allows, and after all other interventions are completed).
# Perform 12-lead ECG (if trained) as indicated.
# Monitor for signs of respiratory distress.

{| class="wikitable"
|AEMT – Advanced Emergency Medicine Tech ''Perform/Confirm All Above Interventions''
|}

# Initiate IV.
# Administer '''NS fluid bolus''', TKO (do not delay transport).

{| class="wikitable"
|Intermediate/Paramedic ''perform/confirm all above interventions''
|}

# Once an IV is established, administer '''Zofran 4mg IV'''.
# After IV Zofran is administered, then administer '''Glucagon 1mg IV'''.
## Record the exact time of Glucagon administration.
## Monitor for nausea/vomiting.
# If still transporting 15 minutes after administration, can provide a trial of PO liquid to evaluate for bolus clearance and ability to swallow.
# Ensure receiving facility is informed of the time of Glucagon administration.

2-23 ESOPHAGEAL FOOD BOLUS IMPACTION - Revision history