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Foreign bodies causing asphyxiation in children: the experience of the Buenos Aires Pediatric ORL Clinic
  1. A Chinski,
  2. F Foltran,
  3. D Passali,
  4. L Bellussi,
  5. D Gregori*
  1. Correspondence University of Padova, Via Loredan 18 Padova, 35100, Italy

Abstract

Rationale and aim The inhalation/aspiration, of a foreign body (FB) is a relatively frequent event in young children. Size, shape, type and site of arrest of the FB are responsible of an important variability on clinical picture, therefore, the possibility to know details regarding object characteristics and traumatic event dynamics have a key role. In the present paper, experience coming from the Children's Hospital in Buenos Aires, Argentina, is presented and our observations are compared with information coming from four well known case series already published and chosen as representative of other cultural and geographical background.

Methods A prospective study in Children's Hospital Gutierrez, Buenos Aires, Argentina, was realised on children having inhaled/aspired a FB, with regard to age and sex distribution, FB type, dimensions and consistency, FB location, clinical presentation, removal and occurrence of complications.

Results Over 1 year, 65 cases of FB inhalation were observed. The children mean age was 4.03 years (SD 1.93). Injuries happened in the major part of cases at home (53 cases (81.53%)) and under adult supervision (59 cases (90.76%)). Children frequently inhale small objects having a rigid consistency. Although the most frequent FB are nuts, differently from other cases series in which injuries are commonly due to food inhalation or aspiration, the major part of accidents in our experience are related with the inhalation of an inorganic FB. Observed complications were pneumonia (3 cases), atelectasis (2 cases) and pneumonitis (1). No deaths were recorded.

Conclusions The high frequency of inorganic FB related injuries testifies that children have the possibility to play with objects, such as pins and nails, not adequate for their age and adults are non-conscious of the choking risk associated with some objects or behaviours. In fact, often injuries happen under adult supervision. Unfortunately, in scientific literature data regarding the dynamic of the accident and particularly the adult presence are frequently underreported; however, when information is at a disposal, it confirms the idea that more effort in caregivers' public education is needed and that information about this issue should be included in all visits to family paediatricians.

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