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Published on: September 11, 2018
Need for more clear parental recommendations regarding foreign body aspiration in children
Rikke Haahr Iversen1, Tejs Ehlers Klug
1Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, 8000 Aarhus C, Denmark. rikkehaahr@hotmail.com
Insights
Foreign body aspiration in children, especially under three, requires prompt bronchoscopy. Awareness of choking hazards like nuts and carrots is crucial for prevention.
Area of Science:
- Pediatrics
- Emergency Medicine
- Otolaryngology
Background:
- Foreign body (FB) aspiration is a significant cause of respiratory distress in young children, peaking between 1-2 years.
- Risk factors include immature swallowing, incomplete dentition, and distractibility during eating.
- Symptoms range from asymptomatic to severe airway distress.
Purpose of the Study:
- To evaluate the characteristics and outcomes of foreign body aspiration in children.
- To emphasize the importance of bronchoscopy in suspected cases, regardless of initial findings.
Main Methods:
- Retrospective review of children (0-15 years) with suspected foreign body aspiration.
- Inclusion criteria: confirmation of foreign body by bronchoscopy.
Main Results:
- A foreign body was confirmed in 59 of 136 children (43.4%) who underwent bronchoscopy.
- The median age was one year; 48% presented with persistent cough, and 19% had normal physical exams.
- Nuts (34%) and carrots (20%) were the most common foreign bodies, with organic materials predominating (86%).
Conclusions:
- Parental suspicion warrants acute bronchoscopy, even with normal initial examinations.
- Prompt bronchoscopy (within 24 hours) reduces complication risks.
- Increased awareness of choking hazards from small, crunchy organic foods (nuts, carrots) in children under three is recommended.
Introduction:
Foreign body (FB) aspiration is a common cause of respiratory emergency in early childhood and is associated with a high rate of airway distress. FB aspiration peaks at the age of 1-2 years. Factors placing children at higher risk include incomplete dentition, immature swallowing coordination and the tendency to be easily distracted while eating. Symptoms may vary from an un-affected child to impending airway failure. Mucosal cough receptors often accommodate and the child may be asymptomatic when evaluated.
Material And Methods:
Files of children (0-15 years) admitted with suspected FB aspiration were reviewed. Patients were included if the FB was confirmed by bronchoscopy.
Results:
Among 136 children undergoing bronchoscopy, a FB was confirmed in 59 patients. The median age was one year. All children had a history of aspiration and in 48% a persistent cough was present at the initial examination. Eleven children (19%) had a normal physical examination at admission. Nuts were identified in 34% and carrots in 20%. Of the FBs removed, 86% were organic and 14% were inorganic. Organic FBs were more common in patients younger than three years (p < 0.001).
Conclusion:
Parental suspicion of FB aspiration indicates acute bronchoscopy in children, even in case of no abnormal findings. The completion of the bronchoscopy within 24 hours facilitates the examination and reduces the risk of complications. We recommend increased awareness of the hazards associated with small crunchy organic food items, especially nuts and carrots, given to children under three years of age.
Funding:
not relevant.
Trial Registration:
not relevant.
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