Pediatric Airway Foreign Body Follow-up

Updated: Sep 06, 2018
  • Author: Emily Concepcion, DO; Chief Editor: Girish D Sharma, MD, FCCP, FAAP  more...
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Follow-up

Further Outpatient Care

In one series of 98 foreign body aspirations, 74.5% of the radiographs were normal within one week. [12] A longer time until clearing was associated with inflammatory changes on the initial radiograph or direct visualization, a procedure time longer than 50 minutes, and respiratory complications during the removal.

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Further Inpatient Care

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  • Endoscopy must be performed by a physician skilled in pediatric airway procedures. Ideally, an anesthesiologist skilled in the treatment of children should also be present in the operating room.

  • Once the foreign body has been removed and the patient is stable, the child may be discharged. This usually occurs the same day as the procedure.

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Inpatient & Outpatient Medications

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  • If swelling or granulation tissue was observed, a corticosteroid may be administered.

  • Unless airway secretions are infected, antibiotics are not necessary.

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Deterrence/Prevention

The best prevention is avoidance.

Anticipatory guidance should include information about age-appropriate foods and instructing the child to sit at the table until all chewing is complete. Supervise children during eating.

Talking while chewing should also be discouraged.

Anticipatory guidance should also include information about age- and size-appropriate toys. Toys that often cause choking include marbles, balloons, batteries from toys, and balls with a diameter of less than 1.75 inches. Children younger than 3 years should not be allowed to play with toys with small pieces. Older children should be supervised when playing with these toys. Keep older children's toys out of the reach of younger children.

Cardiopulmonary resuscitation and choking first aid for children should be taught to parents, teachers, childcare providers, and others who care for children, especially children at high risk of choking such as children with swallowing disorders, neuromuscular disorders, developmental delay, traumatic brain injury, and other primary and secondary medical conditions that may adversely affect the complex neuromuscular coordination involved in the swallowing process. [13]

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Complications

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  • Atelectasis due to prolonged airway obstruction

  • Bronchiectasis due to chronic infection

  • Lung abscess

  • Pneumomediastinum and pneumothorax (rare complications of foreign body removal)

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Prognosis

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  • Once the foreign material is removed, the prognosis is excellent. The sooner it is removed, the quicker and more complete the recovery.

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Patient Education

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  • For excellent patient education resources, see eMedicineHealth's patient education articles, Choking and Swallowed Object.

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