Livin' on the MDedge

Sleep vs. Netflix, and grape juice BPAP


Stuck between a tongue and a hard place

There once was a 7-year-old boy who loved grape juice. He loved grape juice so much that he didn’t want to waste any after drinking a bottle of the stuff.

Three bottles of juice Shablon/Getty Images

To get every last drop, he tried to use his tongue to lick the inside of a grape juice bottle. One particular bottle, however, was evil and had other plans. It grabbed his tongue and wouldn’t let go, even after his mother tried to help him.

She took him to the great healing wizards at Auf der Bult Children’s Hospital in Hannover, Germany – which is quite surprising, because they live in New Jersey. [Just kidding, they’re from Hannover – just checking to see if you’re paying attention.]

When their magic wands didn’t work, doctors at the hospital mildly sedated the boy with midazolam and esketamine and then advanced a 70-mm plastic button cannula between the neck of the bottle and his tongue, hoping to release the presumed vacuum. No such luck.

It was at that point that the greatest of all the wizards, Dr. Christoph Eich, a pediatric anesthesiologist at the hospital, remembered having a similar problem with a particularly villainous bottle of “grape juice” during his magical training days some 20 years earlier.

The solution then, he discovered, was to connect the cannula to a syringe and inject air into the bottle to produce positive pressure and force out the foreign object.

Dr. Eich’s reinvention of BPAP (bottle positive airway pressure) worked on the child, who, once the purple discoloration of his tongue faded after 3 days, was none the worse for wear and lived happily ever after.

We’re just wondering if the good doctor told the child’s mother that the original situation involved a bottle of wine that couldn’t be opened because no one had a corkscrew. Well, maybe she reads the European Journal of Anaesthesiology.



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