The soiled paediatric airway ‐ a case report and literature review of massive soil aspiration

Summary Massive aspiration of garden soil is a rare but potentially fatal event in children. Definitive hospital management requires collaborative multidisciplinary care. We present the case of an 11‐month old who suffered massive aspiration of soil after pulling the contents of a large pot plant onto himself. We discuss recommended initial airway management, definitive soil removal techniques, and the role of steroids, antibiotics and tetanus prophylaxis in such cases. We also outline potential long‐term sequelae and highlight the need for long‐term follow‐up. Treatment priorities for such events can be summarised as: optimisation of airway and gas exchange whilst minimising passage of further material past the vocal cords, definitive removal of macroscopic soil from the larger respiratory passages, supportive respiratory care whilst assisting the muco‐ciliary mechanism to clear remaining soil and antibiotic and parasitic cover to prevent respiratory infection and long‐term sequelae.