Foreign object - inhaled

Definition

If you breathe a foreign object into your nose, mouth, or respiratory tract, it may become stuck. This can cause breathing problems or choking. The area around the object also can become inflamed or infected.

Alternative Names

Obstructed airway; Blocked airway

Considerations

Children ages 6 months to 3 years are the age group most likely to breathe in (inhale) a foreign object. These items may include nuts, coins, toys, balloons, or other small items or foods.

Causes

Young children can easily inhale small foods (nuts, seeds, or popcorn) and objects (buttons, beads, or parts of toys) when playing or eating. This may cause a partial or total airway blockage.

Young children have smaller airways than adults. They also can't move enough air when coughing to dislodge an object. Therefore, a foreign object is more likely to get stuck and block the passage.

Symptoms

Symptoms include:

• Choking
• Coughing
• Difficulty speaking
• No breathing or breathing trouble (respiratory distress)
• Turning blue, red or white in the face
• Wheezing
• Chest, throat or neck pain

Sometimes, only minor symptoms are seen at first. The object may be forgotten until symptoms such as inflammation or infection develop.

First Aid

First aid may be performed on an infant or older child who has inhaled an object. First aid measures include:

• Back blows or chest compressions for infants
• Abdominal thrusts for older children

Be sure you are trained to perform these first aid measures.

Any child who may have inhaled an object should be seen by a doctor. A child with a total airway blockage requires emergency medical help.

If choking or coughing goes away, and the child does not have any other symptoms, he or she should be watched for signs and symptoms of infection or irritation. X-rays may be needed.

A procedure called bronchoscopy may be needed to confirm the diagnosis and to remove the object. Antibiotics and breathing therapy may be needed if an infection develops.

Do Not

DO NOT force feed infants who are crying or breathing rapidly. This may cause the baby to inhale liquid or solid food into their airway.

When to Contact a Medical Professional

Call a health care provider or local emergency number (such as 911) if you think a child has inhaled a foreign object.

Prevention

Preventive measures include:

• Keep small objects out of the reach of young children.
• Discourage talking, laughing, or playing while food is in the mouth.
• Do not give potentially dangerous foods such as hot dogs, whole grapes, nuts, popcorn, food with bones, or hard candy to children under age 3.
• Teach children to avoid placing foreign objects into their noses and other body openings.
  
  

References

Marcdante KJ, Kliegman RM. Upper airway obstruction. In: Kliegman RM, Stanton BF, eds. Nelson Essentials of Pediatrics. 7th ed. Philadelphia, PA: Elsevier; 2015:chap 135.

Schroeder JW, Holinger LD. Foreign bodies in the airway. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 387.

Shah SR, Little DC. Ingestion of foreign bodies. In: Holcomb GW, Murphy JP, Ostlie DJ, eds. Ashcraft's Pediatric Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 11.

Thomas SH, Goodloe JM. Foreign bodies. In Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA.: Elsevier; 2018:chap 53.