A fractured nasopharyngeal swab in the duodenum of a toddler: an unusual complication of preoperative COVID-19 testing

Tümer, Murat; Ardicli, Burak

doi:10.1007/s12630-021-01995-3

Cited by 3 publications

(8 citation statements)

References 3 publications

(3 reference statements)

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“…Finally, 27 articles were selected for review. 3 11 12 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 40 41 …”

Section: Complications Related With Nasopharyngeal Covid-19 Testingmentioning

confidence: 99%

“…All the researched complications due to nasopharyngeal COVID-19 testing were classified, and the related information is shown ( Table 1 ). Retained swabs 3 12 16 17 18 20 21 24 26 27 32 35 due to swab fracture during the examination and epistaxis 3 12 17 24 28 32 were the frequently reported complications. Cerebrospinal fluid (CSF) leakage 3 11 12 15 22 23 28 29 30 33 34 36 was a frequently documented serious adverse event requiring prompt attention and evaluation.…”

Section: Complications Related With Nasopharyngeal Covid-19 Testingmentioning

confidence: 99%

“…However, numerous complications, from minor to even fatal ones, have been repetitively reported in the media 13 14 and literatures 3 11 12 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 although complications required further medical evaluation were rarely happened ranging from 0.0012% 24 to 0.026%. 20 In addition, excessive quarantine burden and stressful condition of the COVID-19 pandemic 37 38 occasionally causes uncomfortable testing by the examiner who may not fully understand the nasopharyngeal anatomy or clinically cautious events related to nasopharyngeal swabs.…”

Section: Introductionmentioning

confidence: 99%

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Complications of Nasopharyngeal Swabs and Safe Procedures for COVID-19 Testing Based on Anatomical Knowledge

Kim

Moon

et al. 2022

J Korean Med Sci

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Nasopharyngeal swabs have been widely to prevent the spread of coronavirus disease 2019 (COVID-19). Nasopharyngeal COVID-19 testing is a generally safe and well-tolerated procedure, but numerous complications have been reported in the media. Therefore, the present study aimed to review and document adverse events and suggest procedural references to minimize preventable but often underestimated risks. A total of 27 articles were selected for the review of 842 related documents in PubMed, Embase, and KoreaMed. The complications related to nasopharyngeal COVID-19 testing were reported to be rarely happened, ranging from 0.0012 to 0.026%. Frequently documented adverse events were retained swabs, epistaxis, and cerebrospinal fluid leakage, often associated with high-risk factors, including severe septal deviations, pre-existing skull base defects, and previous sinus or transsphenoidal pituitary surgery. Appropriate techniques based on sufficient anatomical knowledge are mandatory for clinicians to perform nasopharyngeal COVID-19 testing. The nasal floor can be predicted by the line between the nostril and external ear canal. For safe testing, the angle of swab insertion in the nasal passage should remain within 30° of the nasal floor. The swab was gently inserted along the nasal septum just above the nasal floor to the nasopharynx and remained on the nasopharynx for several seconds before removal. Forceful insertion should be attempted, and alternative examinations should be considered, especially in vulnerable patients. In conclusion, patients and clinicians should be aware of rare but possible complications and associated high-risk factors. The suggested procedural pearls enable more comfortable and safe nasopharyngeal COVID-19 testing for both clinicians and patients.

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“…Finally, 27 articles were selected for review. 3 11 12 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 40 41 …”

Section: Complications Related With Nasopharyngeal Covid-19 Testingmentioning

confidence: 99%

Section: Complications Related With Nasopharyngeal Covid-19 Testingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Complications of Nasopharyngeal Swabs and Safe Procedures for COVID-19 Testing Based on Anatomical Knowledge

Kim

Moon

et al. 2022

J Korean Med Sci

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“…13 And for a final article from this Special Issue to be highlighted here, Tümer and Ardıçlı share with us the tale of a toddler who was less than delighted with his concerned healthcare providers’ idea to advance a COVID-19 swab into her nasopharynx for preoperative testing. 14 The swab stick fractured and, disconcertingly, a 5-cm fragment disappeared without a trace. As is the case for many a good story, there is a happy end, but we will let you read for yourself.…”

mentioning

confidence: 98%

“…13 Dans le dernier article de ce Numéro spécial que nous mentionnerons dans cet éditorial, Tümer et Ardıçlı nous partagent l’histoire d’un bambin qui n’était vraiment pas ravi par l’idée de ses fournisseurs de soins de santé inquiets qui voulaient introduire un écouvillon pour la COVID-19 dans son nasopharynx afin de procéder à un test préopératoire. 14 Le bâton d’écouvillon s’est rompu et, de manière tout à fait déconcertante, un fragment de 5 cm a disparu, sans laisser de trace. Comme c’est le cas pour beaucoup de belles histoires, celle-ci finit bien, mais nous vous laisserons la lire par vous-même.…”

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Editors’ note: 2021 Special Issue on airway management

Schwarz

Jones

2021

Can J Anesth/J Can Anesth

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Sinonasal Lobular Capillary Hemangioma After Continuous Self-tests for COVID-19: A Case Report and Review of the Literature

FOUNTARLIS¹,

LACHANAS²,

ZACHAROULI³

et al. 2022

MMJ

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Sinonasal lobular capillary hemangiomas (LCH) are rare benign vascular lesions commonly arising from the nasal septum. Nasopharyngeal, nasal mid-turbinate, and anterior nasal swabbing is the preferred method of screening for coronavirus disease-2019 (COVID-19). Herein, we present a case of a sinonasal LCH in a child after continuous self-tests for COVID-19, with an anterior nasal swab. The child presented with a well-defined red mass in the anterior part of the nasal septum, which was removed endoscopically. Histopathology revealed a LCH. This is the first report of a complication other than epistaxis with the use of an anterior nasal swab. Our literature review identified 32 studies reporting complications of COVID-19 screening. Cerebrospinal fluid leaks and foreign body retention are the most common ones. A proper specimen collection technique and a quick patient history with an emphasis on risk factors are the best practices to prevent complications from COVID-19 screening.

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A fractured nasopharyngeal swab in the duodenum of a toddler: an unusual complication of preoperative COVID-19 testing

Cited by 3 publications

References 3 publications

Complications of Nasopharyngeal Swabs and Safe Procedures for COVID-19 Testing Based on Anatomical Knowledge

Complications of Nasopharyngeal Swabs and Safe Procedures for COVID-19 Testing Based on Anatomical Knowledge

Editors’ note: 2021 Special Issue on airway management

Sinonasal Lobular Capillary Hemangioma After Continuous Self-tests for COVID-19: A Case Report and Review of the Literature

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