Foreign Body Ingestion or Aspiration
All of us are familiar with the warning “Choking Hazard- not for use by children younger than 3 years” boldly mentioned on the boxes of toys. Foreign body ingestion or aspiration is a fairly common emergency amongst toddlers and small children who generally tend to put small objects in their mouth/nose and then choke on them. This can sometimes be life threatening if the foreign body goes down the windpipe and blocks breathing. Another common presentation of foreign body aspiration is that of older children trying to blow or suck in on the whistles found in the plastic toys.
What do we do when we see a child choking on a foreign body and struggling?
There are a few things we can do or must remember not to do in such situations and remembering these tips may come handy in probably saving the life of a child. Here’s a look:
Do not panic or try to pull out the foreign body by putting your finger inside especially when the child is struggling and crying. Sit on a chair, keep the child across your lap with its head lower than the body and give 5 sharp slaps on the back between the shoulder blades. Alternate this with 5 chest thrusts holding the child in a standing position and encircling him/her from the back and using both your hands thrusting up just below the breast bone.
BUT REMEMBER TO ATTEMPT THESE ONLY IF THE CHILD IS AWAKE AND CONSCIOUS
If this fails and the foreign body is still in the airway we should rush the child to a hospital where it is removed in the operation theatre. This is done by passing a rigid tube with a telescope down the windpipe, visualizing the foreign body and removing it with a forcep mounted on a telescope. This procedure is called bronchoscopy. Sometimes the foreign body is not dangerous enough to be life threatening and can wait till we take x rays and confirm its location, to plan its removal.
Foreign bodies in the food pipe or stomach are less life threatening except if they are sharp objects or chemicals especially corrosives like acid and alkalis which are commonly used as household cleaning agents. Another potentially dangerous foreign body is the small button alkaline batteries, which can cause serious injury to the stomach or food pipe. One important point to remember is never to induce vomiting after foreign body ingestion as chemicals agents as this can cause more widespread damage.