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. [23, 24]
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.