We all know we should look both ways before crossing the street, but we should also look twice before puffing our asthma inhaler. A woman in Australia learned a very important lesson after being rushed to the hospital on New Year’s Eve. The 41-year-old accidentally inhaled one of her earrings after reaching into her purse for her uncapped asthma pump to alleviate her mild wheeze, according to the case report recently published in BMJ Case Reports.

The woman admitted she heard a “coarse rattle” in her blue salbutamol inhaler when she shook it. However, she ignored the noise and believed it was due to a loose connection inside the device. The asthma sufferer began to have a severe scratch at the back of her throat and quickly proceeded to cough up blood, wheeze, and experience a shortness of breath.

Originally, she thought she swallowed a piece of foil from a medical pack in her purse, but doctors found a hidden treasure in her chest. A chest X-ray immediately revealed an abnormality that had "features consistent with a stud earring," said Dr. Lucinda Blake, one of the doctors who treated the woman, LiveScience reported. The CT scan confirmed the earring was stuck in the woman’s right bronchus — one of the two main airways leading from the trachea, also known as windpipe, into the lungs.

Woman's chest X-ray shows earring lodged in lung
Woman's chest X-ray shows the earring in her right bronchus, an airway that leads to the lungs. BMJ

Foreign body aspiration can be a life-threatening emergency when an aspirated solid or semisolid object is lodged in the larynx or trachea. If the object is large enough that it can cause almost complete obstruction in the airway, says Medscape, asphyxia may rapidly cause death. If the earring caused near-total obstruction of the larynx or trachea, the woman would have most likely been dead after inhalation.

Luckily, doctors were able to treat her with antibiotics to prevent infection. They also conducted a bronchoscopy by inserting a thin, flexible tool with a camera into her throat. There they were able to examine her bronchus and remove the earring. Blake found large amounts of mucus around the earring, which was "likely the body's attempt to expel the foreign body."

Blake believes many asthma patients commit the same mistakes seen in this case report. "I think that teaching should include explaining to patients the importance of replacing inhaler caps, teaching them how to inspect their inhalers thoroughly to ensure that there are no unwanted objects concealed, and educating them on the potential damage inhaled objects can cause," she said.

Earring lodged in woman's right bronchus during bronchoscopy
This image shows the earring lodged in the woman's right bronchus during the bronchoscopy. BMJ

Inadequate techniques reduce the effects of inhalation medication. About 85 percent of patients commit errors in inhalation technique and fail to maintain proper hygiene practices with their device, including putting a cap on it. Blake’s asthma patient now makes sure to inspect her inhaler before she uses it.