Alternate Names: Swallowed foreign object; Obstructed airway; Inhalation of a foreign object

Considerations: Aspiration may occur at any age but is more commonly seen in the 1 to 3 year-old age group.

Causes:

• Certain foods (nuts, seeds, popcorn) and small objects (buttons, beads) may easily be aspirated by young children. Such objects may cause either partial or total airway occlusion.
• Coins, small toys, marbles, pins, screws, rocks, and anything else small enough for infants or toddlers to put in their mouths can be swallowed. If the object passes through the esophagus and into the stomach, without lodging; it will probably pass through the entire digestive tract.

Symptoms: Aspiration of tiny foreign objects are usually noted immediately with coughing, wheezing, respiratory distress or total lack of air exchange. However, aspiration may cause only minimal initial symptoms and be forgotten until later symptoms related to local inflammation or infection develop.

Do Not:

• DO NOT "force feed" infants that are crying or breathing rapidly.

Call If:

• a child is believed to have either aspirated or swallowed an object.

First Aid: FOR ASPIRATION:
Any child who is believed to have aspirated an object should be evaluated by the primary health care provider. Children with obvious respiratory distress may require emergency measures for total airway occlusion. If choking, coughing, subsides and the child is not exhibiting any other symptoms; he or she may be monitored for developing signs and symptoms of respiratory infection or irritation. X-rays may be helpful for diagnosis. Bronchoscopy may be necessary for definitive diagnosis as well as removal of the object. Antibiotics may be used and respiratory therapy techniques if infection develops.

FOR INGESTION:
Any child who is believed to have swallowed a foreign object should be observed for pain, fever, vomiting, or local tenderness. Stools (bowel movements) should be examined to detect passage of the foreign object. Even sharp objects (such as pins, screws) usually pass through the GI tract without complications. X-ray examination is typically not necessary unless the child demonstrates symptoms of distress or the object does not pass within 4 to 5 days. Only 2 to 4% of such cases eventually require surgery for removal of the object.

Prevention:

• Do not give children under 3 potentially dangerous foods such as: hot dogs, whole grapes, nuts, popcorn, hard candy.
• Keep small objects out of infant and toddler’s reach.
• Cut food into appropriate sizes for small children and teach adequate chewing.
• Discourage talking, laughing, or playing while food is in the mouth.