Choking in children


Food or other foreign body aspiration represents a frequent life threatening condition, mainly in children under the age of 3, who already possess the ability of independent movement and use it to discover their surroundings. The management of these situations has a number of significant characteristics, from active expectoration support and eventual resuscitation to often necessary invasive intervention. How to perform the first aid and remove the foreigner body from the airway? With this algorithm, we invite you to experience a model situation that each of us can go through.

2019
choking
bronchoscopy
laryngospasm
Published at: 22.5.2019

Review

Jan Divák, MD, PhD, MBA
Chief Physician of Anesthesia, Department of Anaesthesia, Resuscitation and Intensive Care Medicine, University Hospital in Ostrava, Ostrava, Czech Republic

Foreign body aspiration in children is an acute, sometimes even an urgent situation faced by doctors of various medical specialties: emergency department doctors, anaesthesiologists, intensivists, ENT specialists or pulmonologists. Their common goal is to solve this acute problem and save the child. However, for the majority of doctors, foreign body aspiration in children does not represent a well-known routine situation. Actually, I think the majority would consider it to be highly stressful. This interactive algorithm created by Akutne.cz is well-arranged and comprehensibly structured in its full length, beginning with basic first aid and professional prehospital emergency care, through hospital admission and foreign body extraction under general anaesthesia to the consecutive care at the ICU. In my opinion, this algorithm is flawlessly crafted, and I highly appreciate that it is possible to learn from your own mistakes in each step. The algorithm surely is beneficial not only for anaesthesiologists, but also for a wide group of doctors, who might come across such a situation.

Sources

MILLER, Ronald D., Manuel PARDO and Robert K. STOELTING. Basics of anesthesia. 7th ed. Philadelphia, PA: Elsevier/Saunders, c2017. ISBN 1437716148.

BARASH, Paul G., Bruce F. CULLEN and Robert K. STOELTING. Klinická anesteziologie. Praha: Grada, 2015. ISBN 978-80-247-4053-9.

RUIZ, Fadel E. Airway foreign bodies in children. UpToDate [online]. Waltham: UpToDate Inc. 2018 [Accessed 3 January 2019]. Available at: https://www.uptodate.com/contents/airway-foreign-bodies-in-children

WARD, Christopher. Anesthesia for the child with an inhaled foreign body. UpToDate [online]. Waltham: UpToDate Inc. 2018 [Accessed 21 November 2018]. Available at: https://www.uptodate.com/contents/anesthesia-for-the-child-with-an-inhaled-foreign-body

COLT, Henri G. Rigid bronchoscopy: Intubation techniques. UpToDate [online]. Waltham: UpToDate Inc. 2017 [Accessed 15 October 2018]. Available at: https://www.uptodate.com/contents/rigid-bronchoscopy-intubation-techniques 

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