Inhalation, Foreign Body
Description Diagnostic criteria General and supportive measures Referral ICD-10 code : T17.9 DESCRIPTION Accidental inhalation of a solid object that may obstruct the airway at any level. DIAGNOSTIC CRITERIA Ask specifically about a possible choking episode if there is any suspicion of a foreign body aspiration. Initial symptom is frequently sudden onset of choking followed by persist
General and supportive measures
ICD-10 code: T17.9
DESCRIPTION
Accidental inhalation of a solid object that may obstruct the airway at any level.
DIAGNOSTIC CRITERIA
Ask specifically about a possible choking episode if there is any suspicion of a foreign body aspiration.
- Initial symptom is frequently sudden onset of choking followed by persistent unilateral wheeze (may be bilateral), chronic cough, or stridor.
- Segmental or lobar pneumonia failing to respond to standard therapy.
- Mediastinal shift.
- Chest X-ray on full expiration and full inspiration may show hyperinflation and/or collapse or sometimes, a radio-opaque foreign body.
GENERAL AND SUPPORTIVE MEASURES
ACUTE EPISODE
- If coughing effectively and breathing adequately, provide oxygen and refer urgently for airway visualisation. Carry out transfer with a person who is able to manage the foreign body process accompanying the child.
- If the child is still breathing but unable to cough or breathe adequately, attempt to dislodge the foreign body by cycles of 5 back slaps followed by 5 chest compressions (infants), or 5 Heimlich manoeuvres (child) repeatedly.
- If the child is unresponsive carry out standard cardiorespiratory resuscitation, i.e. cardiac compressions and ventilation (provide artificial breaths at a ratio of 30 compressions to 2 breaths (30:2) if alone and 15 compressions to 2 breaths (15:2) if two rescuers are present.
Caution:
Blind finger sweeps are dangerous and absolutely contra-indicated.
Foreign bodies may be removed under direct vision.
All cases should have airway visualisation or be referred for airway visualisation.
REFERRAL
- All cases for the removal of retained foreign bodies.
- Unresolved respiratory complications.
Standard Treatment Guidelines And Essential Medicines List For South Africa, Hospital Level, Paediatrics, 2023 Edition
Chapter 1: Emergencies and Trauma, 1.1 Paediatric Emergencies, 1.1.7 Inhalation, Foreign Body