Inhalation of the Cap of a Metered-Dose Inhaler

To the Editor: A 25-year-old man with asthma awoke one night with wheezing and shortness of breath. Still groggy from sleep, he reached for the albuterol metered-dose inhaler on his bedside stand, placed his lips over the inhaler, and took a deep, rapid breath. Unfortunately, he did not remove the cap of the inhaler and aspirated the cap into the larynx. Despite vigorous coughing and expectoration, he was initially unable to dislodge the inhaler cap. Frantic from the near-total obstruction of the upper airway, the patient was finally able to remove the cap with the index and middle fingers of . . .