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Foreign-Body Aspiration: A Pediatric Airway Emergency

Blind sweeping of the mouth is not recommended. Infants require back blows and chest compressions, and children older than one year require abdominal thrusts. In severe cases of complete airway obstruction, direct laryngoscopy and foreign body removal with Magill forceps should be attempted emergently. If the foreign body is not visualized, endotracheal intubation should be performed, which will potentially dislodge the foreign body and move it more distally. In the rare cases in which the patient cannot be ventilated after the measures above, needle cricothyroidotomy can be a temporizing life-saving procedure.4

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 A Screwy Case of Pediatric Shortness of Breath

Airway foreign bodies (FB) are a common complaint in the pediatric population. Infants and toddlers explore the world around them by putting objects into their mouths, so it is unsurprising that children aged 6 months to 3 years are the most common age group to present with choking or a concern for FB aspiration. Younger children are at increased risk for significant airway obstruction because of their narrow airways. Their underdeveloped communication skills and unreliable histories further complicate clinical scenarios. Laryngotracheal FBs are most likely to present with acute respiratory distress, hoarseness, or stridor. Bronchial FBs are more likely to present with coughing, wheezing, diminished breath sounds, pain, shortness of breath, or infectious symptoms. Children frequently present with only mild symptoms

 POTD- Foreign body aspiration

Normal presentations goes something like this... My child was playing on the floor and the next thing I know they were coughing and now they are making a funny noise and look like they are struggling to breath. So what do you?

Articles of Interest

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Presentation of foreign body inhalation can range from nonspecific respiratory symptoms to respiratory failure associated with a choking episode.

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Chest radiographs are excellent in detecting radiopaque objects. However, most aspirations are from radiolucent organic matters such as nuts or seeds. Radiographs that show focal area of hyperinflation, mediastinal shift, and atelectasis are highly specific for aspiration.

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