PREVENTION AND MANAGEMENT OF AERODIGESTIVE FOREIGN BODY INJURIES IN CHILDHOOD
Section snippets
DIAGNOSTIC EVALUATION
The evaluation and correct diagnosis of a child who experiences a choking event invariably falls on the shoulders of the pediatrician. This responsibility is made more difficult because the parents and other caretakers often have not observed the child ingest and choke on food or another object and do not provide a history that elicits the proper examination and evaluation. Yet, too often, the pediatrician is improperly held responsible for the late diagnosis, when symptoms are absent or
RADIOLOGIC STUDIES
Radiographic examination should be considered and offered unless there is sufficient evidence that the precipitating episode was self-limited and no evidence of residual disease is present. For example, if a child is observed by the parent to choke on a penny that is coughed out, and he or she is without symptoms and is not in distress, he or she may not require radiographic evaluation. However, for all children with an incomplete history and the clinical suspicion of choking, the initial
PROGRESSION OF DISEASE
Undiagnosed foreign bodies invariably cause infection and sometimes death. The sequence of events from the initial choking event to the correct diagnosis is an evolving and constantly changing medical picture, wherein the probability that a foreign body is present looms larger and larger. The early picture is generally of a healthy child with minor complaints. Children who have foreign bodies present for weeks or months become invariably sicker, and the clinical findings of pneumonia,
ROLE OF BRONCHOSCOPY AND ESOPHAGOSCOPY
The correct diagnosis can best be attained by direct endoscopic evaluation of the aerodigestive tract, but this is not practical or cost effective for the millions of children who choke when eating at home or at restaurants. Physicians have the responsibility and the right to determine when bronchoscopy, esophagoscopy, or both should be performed. When the child's diagnosis is unclear, or when symptoms are unexplained, then direct examination by bronchoscopy, esophagoscopy, or both is necessary.
FUTURE GOALS OF FOREIGN BODY SAFETY
Pediatricians are the most important leaders in advocating public health issues that protect young children. Great progress has been made to reduce mortality from almost 100% to 0.01% in just 100 years. Federal regulations over the last 25 years have forced manufacturers to restrict products intended for children fewer than 3 years of age to a minimum size that exceeds the dimensions of the Small Parts Test Fixture (SPTF) (31.7 mm in diameter by 57.1 mm in depth).4, 9 These regulations have
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Cited by (69)
Pulmonary manifestations masquerading a longstanding neglected metallic foreign body in the esophagus of a paediatric patient from Tanzania: Rare case report
2023, International Journal of Surgery Case ReportsEvaluation and Management of Airway Foreign Bodies in the Emergency Department Setting
2023, Journal of Emergency MedicineDelayed diagnosis of esophageal foreign body: A case report
2017, International Journal of Surgery Case ReportsPediatric Respiratory Emergencies
2016, Emergency Medicine Clinics of North AmericaCitation Excerpt :Although recognition and management has improved, foreign body aspiration (FBA) remains common in children. FBA can occur in children of all ages, although most occurrences are in children younger than 4 years, with a peak incidence between the first and second birthdays.1 White and colleagues2 reviewed FBA cases from 1955 to 1960 and compared these with FBA cases from 1999 to 2003.
Physical Hazards
2014, Encyclopedia of Toxicology: Third EditionCHARACTERISTICS AND OUTCOMES OF AERODIGESTIVE FOREIGN BODIES IN CHILDREN
2023, Journal of Ayub Medical College
Address reprint requests to James S. Reilly, MD, Alfred I. duPont Institute, 1600 Rockland Road, Wilmington, DE 19899
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From the Section of Pediatric Otolaryngology, Department of Pediatrics, Alfred I. duPont Hospital for Children, Wilmington, Delaware (JSR, SPC); the Departments of Otolaryngology (JSR, SPC) and Pediatrics (JSR), Thomas Jefferson Medical College, Philadelphia, Pennsylvania; and Inchcape Testing Services, Oakbrook, Illinois (DS, GR)