A swab snapped off inside a woman’s lung when it was inserted into a breathing tube she had in her neck to test for coronavirus.
A recent medical report revealed how an unnamed patient aged 51 had a routine test while in hospital.
She had recently had tracheostomy surgery – a tube cut into the throat to help with breathing instead of through the nose and mouth, MailOnline reports.
A nurse tested her for Covid-19 by putting a normal swab in through the hole in her neck, because she wasn’t using her nose and mouth so the virus wouldn’t be there if she was infected.
But the swab, which can be snapped to put into a test tube, snapped during the procedure and the end got stuck in the woman’s lung.
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Dr Mohammed Hussain, who dealt with the issue at the University Hospitals of Leicester NHS Trust, said: ‘This case highlights the need for clear guidance on how samples for SARS-CoV-2 are taken from patients with front of neck airways and the potential pitfalls involved.’
Although it was invisible on X-rays and CT scans, doctors could see some unusual swelling in her right lung.
When they put a camera into the lung they found the swab lodged in her airway and were able to pull it out with an endoscopy.
The doctors involved are now warning others about the possibility of swabs breaking during use with vulnerable patients.
She had recently had surgery to remove a fragment of her skull for an unrelated illness, and needed the tracheostomy put in to help her breathe.
The patient was given a routine test before being discharged and admitted to a care home – a standard to prevent infection between the two places, which have many vulnerable patients.
The medics wrote in the BMJ Case Reports journal: ‘During the sampling, part of the swab stylet snapped and was inadvertently dropped through the tracheostomy site.
‘Initial CT imaging was reported as showing no signs of a foreign body but some inflammatory changes [swelling].
‘Bedside flexible endoscopy through the tracheostomy site revealed the swab in a right lobar bronchus. This was subsequently removed by flexible bronchoscopy.’
Swabs are usually wiped around the inside of the person’s throat and nose and then placed in a test tube, when the handle is snapped off.
The handle is significantly longer than the test tube because it has to reach the back of the throat without the person giving the test getting too close to the patient, but only the very tip of the swab actually gets the sample on it and needs testing.
Testers usually have to try to get samples of fluid from the back of the nose and throat because that is where coronavirus fixes onto the body and multiplies.
But the virus may not make it to those parts of the body if the person is breathing through a tracheostomy, meaning fluid samples must be taken directly from the lungs.
Dr Hussain added: ‘The above case highlights the potential dangers of taking a mucosal swab from a trachesotomy site.
‘Heightened concerns around SARS-CoV-2 and wearing full personal protective equipment increase the probability of human error occurring.’
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