Swallowing or inhaling a foreign object

Alternative names
Obstructed airway; Inhaling a foreign object

Definition
If a foreign object is inhaled into the respiratory tract, it may become lodged and cause respiratory problems, as well as inflammation and infection. See also choking.

If swallowed, a foreign object may become lodged along the gastrointestinal (digestive) tract, or pass through.

Considerations
These injuries can occur at any age, but are most common in 1 to 3 year-olds.

Causes

     
  • Certain foods (nuts, seeds, popcorn) and small objects (buttons, beads) are easily inhaled by young children. Such objects may cause either partial or total airway blockage.  
  • 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
Tiny foreign objects that have been inhaled are usually noticed immediately with coughing, wheezing, breathing distress, or total lack of air. However, it may cause only minimal symptoms initially, and be forgotten until later symptoms develop that are related to inflammation or infection.

First Aid

FOR INHALED OBJECT

Any child who may have inhaled an object should be evaluated by a doctor. Children with obvious breathing distress may require emergency measures for total airway blockage.

If choking or coughing subsides, and the child does not have any other symptoms, he or she may be monitored for 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 SWALLOWED OBJECT

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 the passage of the foreign object.

Even sharp objects (such as pins and screws) usually pass through the GI tract without complications. X-ray examination is occasionally necessary, especially if the child demonstrates symptoms of distress or the object does not pass within 4 to 5 days.

Do Not
DO NOT “force feed” infants that are crying or breathing rapidly.

Call immediately for emergency medical assistance if
If a child is believed to have either inhaled or swallowed an object, call your health care provider.

Prevention

     
  • Do not give children under 3 potentially dangerous foods such as hot dogs, whole grapes, nuts, popcorn, or 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.

 

Johns Hopkins patient information

Last revised: December 3, 2012
by Martin A. Harms, M.D.

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