Foreign Body Aspiration

What is Foreign Body Aspiration?

Foreign body aspiration occurs when a small object enters the trachea or bronchi, potentially obstructing the airway. Depending on the size of the object, the trachea may become fully blocked, causing asphyxia and posing a life-threatening risk.

This is most common in children aged 10 months to 3 years, with the highest occurrence between 12-24 months. Common aspirated objects include nuts, seeds, candies, coins, hard food pieces (e.g., apple slices), toys with small parts and hairpins.

When Should You Suspect Foreign Body Aspiration?

• Sudden coughing without any prior illness.
• Difficulty in breathing (dyspnea).

Symptoms

1. Coughing is the primary symptom, as the body tries to expel the foreign object.
2. If the object is large and blocks the trachea:
   • Intense coughing.
   • Dyspnea or cyanosis (bluish discoloration).
3. Delayed symptoms:
   • Fever or persistent cough days later, often with complications such as pneumonia.

How to React

If the child is breathing:

• Do not intervene.
• Take the child to the nearest hospital immediately to ensure everything is fine.
• Based on the child’s history, diagnostic tests (e.g., X-rays, bronchoscopy) may be conducted or simply observe the child for several days.

If the child is not breathing:

• Do not put your hand in the child’s mouth unless the object is clearly visible and easily removable.
• Let the child cough, as this may expel the object naturally.
• Do not hit their back while they are coughing, and do not give water.

Emergency Actions

For Infants (Under 1 Year):

1. Hold the infant so their head is lower than their torso.
2. Deliver 5 back blows between the shoulder blades, directed downward, to dislodge the object.
3. Turn the infant face-up and give 5 chest compressions at nipple level.
4. Repeat until the object is expelled or for up to 2 minutes, then begin CPR (cardiopulmonary resuscitation) if necessary.

For Children Over 1 Year:

1. Place the child on the ground or your lap, leaning them slightly forward.
2. Perform the Heimlich maneuver:
   • Kneel behind the child.
   • Place one fist just above the navel and below the sternum.
   • Grasp your fist with your other hand and apply 5 abdominal thrusts inward and upward.
3. Alternate with 5 chest compressions, pressing inward and upward.
4. Repeat until the object is expelled or for up to 2 minutes, then begin CPR if needed.

Prevention Tips

For children under 5 years old:

• Keep small objects out of reach.
• Remove toys containing small parts, buttons, coins or candy-like medications.

Written by Paediatrician Katerina Katsibardi, MP, PhD