Safe management of airway foreign bodies in children

This is an automatically translated article.

The article was professionally consulted by Specialist Doctor II Tran Van Trong - Specialist in Pediatric Surgery, Plastic Surgery - Aesthetics - Department of General Surgery - Vinmec Danang International Hospital.

1. What is an airway foreign body?

Airway foreign body is the term used to describe foreign objects that have fallen into and become trapped in the larynx or bronchi. Normally, foreign bodies are divided into two main categories including organic and inorganic foreign bodies.
A foreign body in the airway is an accident. If the foreign body is located in the nose, it is usually easy to diagnose and treat, but for the laryngeal or bronchial foreign body, the diagnosis and treatment is relatively difficult and complicated, and many dangerous complications can occur. , the worst case is death. Therefore, airway foreign bodies often refer to foreign bodies in the larynx or bronchi.
Foreign body in the airways is a very unpredictable daily life accident, and can occur at any age, most commonly in young children and difficult to diagnose and treat. The highest mortality rate is among children aged 1-6 years. Most of the deaths occurred in patients with acute asphyxiation or severe infection.

2. Diagnosis of airway foreign body in children

Medical history: learn in detail about the signs of infiltrative syndrome. There can be two cases where there is an infiltration syndrome in the body but they have been eliminated by the body or conversely, there is a foreign body in the body but no intrusion syndrome is found.
Invasion syndrome is a type of protective reflex of the airways, leading to 2 reflexes occurring together: the body reflex constricts the larynx to prevent the foreign body from going down and the other reflex is cough to push. foreign body out. Leading to clinical symptoms are asphyxiation, cyanosis, prolonged cough, ... if not treated promptly, can lead to death.

3. Safe management of airway foreign bodies in children

The current treatment process usually takes place in 2 main stages: primary emergency and specialist emergency.
3.1. First Aid Applied to emergency cases, providing first aid to the patient. For cases of suffocation due to liquids such as milk, powder, ... to open the airways for young children, hold the child's ankles up, and the head must be directed downwards, at the same time the other hand Gently pat the child on the back to help push the object out.

For non-liquid foreign bodies, the Heimlich maneuver should be performed.
For infants > 1 year old, the Heimlich maneuver should be performed in the supine position. For children under 1 year of age, according to medical research, the first aid when a child is asphyxiated should be performed with reverse blowing (similar to artificial respiration) because abdominal trauma is easy to occur when doing Heimlich. Heimlich in the lying position: first, the patient should be placed in the supine position, with the head lowered, and tilted to one side, then the rescuer's hands should be placed on top of each other and pressed right at the epigastric region, and then press firmly. In the direction of the patient's head, proceed rhythmically (press about 4-5 times at a time) to squeeze the lungs so that the air in the lungs can be expelled and at the same time have the ability to push the foreign body out. Heimlich sitting or standing: stand behind the victim's back, bring your hands forward over the hips and in front of the epigastric area, place your hands on top of each other, and at the same time let the victim's back rest on your chest, then Then forcefully press on the victim's epigastrium in batches (also do 4-5 compressions at a time).

3.2. General emergency After clinical diagnosis, the doctor will perform artificial respiration, or conduct tracheostomy for emergency if the patient is found to be asphyxiated:
Check the patient's bronchoscope to remove allergen. Bronchoscopy of patients to remove foreign bodies is the most optimal treatment method today. Commonly used medical instruments: bronchoscope, fluorescent screen, light-emitting diode, 2-wire, 4-wire noose, foreign body pliers... Based on bronchoscopy, the doctor will determine the location. of a foreign body in the child's body and use specialized tools to remove the foreign body. Living accidents caused by foreign bodies in the airways in young children are unpredictable situations in modern life that can take children's lives. With the above methods of safely handling airway foreign bodies in children, hopefully readers have gained more useful knowledge.
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