Inhalation of a plastic wall plug: implications of foreign body characteristics in paediatric patients

Foreign body inhalation causing asphyxiation is a significant cause of death in children under 4 years. Approximately one-fifth of the cases are inorganic industrial objects. We describe the case of an 18-month-old boy who presented with respiratory distress after inhaling a wall plug. An emergency rigid bronchoscopy was performed; however, the nature of the object and its location within the airway proved it difficult to identify at first look, causing the removal to be a challenge even in the most skilled of hands. Furthermore, its design contributed to the severity of obstruction of the airway and hence risk of death. This case prompts a discussion on the safety implications of small inorganic product designs and the measures currently being taken by manufacturers and clinicians to prevent the fatal asphyxiation in children.