Foreign Body Aspiration

Food is the most common foreign body aspirated and has a peak incidence at age 1-2 years.

The usual history obtained is of sudden onset coughing, retching and choking.

Initial treatment of a choking child is as per APLS protocols.

Partial obstruction above or at the vocal cords causes inspiratory stridor, a change in voice, cough and dyspnoea.

Partial obstruction of the lower airway in addition to cough and dyspnoea may cause a pneumothorax, pneumomediastinum or surgical emphysema.

Findings on examination will depend on the site of the obstruction. Findings include cough, wheeze, stridor and pneumonia but there may be a normal examination. An inspiratory chest x-ray may be normal, whilst an expiratory film may demonstrate air trapping [27-29].

Treatment is by removal of the foreign body under general anaesthetic with a rigid bronchoscope.

Click the thumbnail to see an algorithm for treating a choking child.

There is more information on aspiration to be found at www.resus.org.uk

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