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Foreign object - inhaled or swallowed

Definition

If you breathe a foreign object into your nose, mouth, or respiratory tract, it may become stuck and cause breathing problems. It can also lead to inflammation and infection.

If you swallow a foreign object, it can get stuck along the gastrointestinal (GI) tract. This can lead to infection or bleeding.

See also: Choking

Alternative Names

Obstructed airway; Blocked airway

Considerations

Children age 1 to 3 are most like to swallow or breathe in a foreign object, such as a coin, marble, pencil eraser, buttons, beads, or other small items or foods.

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 getting stuck, it will probably pass through the entire GI tract.

Symptoms

• Choking
• Coughing
• No breathing or breathing trouble (respiratory distress)
• Wheezing

However, in some cases, only minor symptoms are seen at first, and the object may be forgotten until later symptoms (inflammation, infection) develop.

First Aid

FOR INHALED OBJECT

Any child who may have inhaled an object should be seen by a doctor. Children with obvious breathing trouble may have a total airway blockage that requires emergency medical attention.

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.

Bronchoscopy may be necessary to make a definitive diagnosis and to remove the object. Antibiotics and respiratory therapy techniques may be used if infection develops.

FOR SWALLOWED OBJECT

Any child who is believed to have swallowed a foreign object should be watched for pain, fever, vomiting, or local tenderness. Stools (bowel movements) should be checked to see if the object exited the body. This may sometimes cause rectal or anal bleeding.

Even sharp objects (such as pins and screws) usually pass through the GI tract without complications. X-rays are sometimes needed, especially if the child has pain or the object does not pass within 4 to 5 days.

Do Not

DO NOT "force feed" infants who are crying or breathing rapidly.

Call immediately for emergency medical assistance if

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

Prevention

• Cut food into appropriate sizes for small children, and teach them how to chew well.
• 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, or hard candy to children under age 3.
• Keep small objects out of the reach of young children.

References

Thomas SH, White BA. Foreign bodies. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 57.