Prevention and management of foreign bodies in the airways in children

The article was written by Nurses Nguyen Thi Mai and Duong Thi Hong - Pediatric Inpatient Department, Vinmec Times City International Hospital

A foreign body in the airway is a common and dangerous accident in young children, especially children under 2 years of age, because foreign objects fall into the airways, causing narrowing or complete obstruction of the airways. This is an emergency condition that, if not handled in time, can lead to serious consequences such as irreversible brain damage or even death.

Due to children choking on food such as porridge, milk, rice... Inhaling common small objects such as nuts, candies, pills..., can also be toys and small objects such as marbles, pen caps, cigarette filters... Choking from phlegm, drinks...

Children suddenly cough, have difficulty breathing, do not cry, quickly turn blue, stop breathing, lethargy, lethargic or comatose, must immediately think of suffocation due to the degree of foreign body in the airway. Obstruction of the airways, which manifests from cough, shortness of breath, weak crying to more severe than not being able to cry, cyanosis, gradually decreasing consciousness to coma.

If the child is still rosy, can cry, can speak, scream, and has no difficulty breathing, parents should put the child in a sitting position to breathe, keep the child still and take him to the hospital to examine and remove the foreign body.
If the child appears pale, has difficulty breathing, does not cry or cries weakly, the parents should quickly call an ambulance, the person to support and conduct the procedure of patting the back, pressing the chest.
For children under 2 years old, back patting and chest compressions are performed as follows:
Place the child on his/her stomach, head low on the left arm, hold the head and neck first with the left hand. Use the index finger and middle finger of the left hand to push the child's chin up to prevent the airway from bending. Use the heel of your right hand to give 5 strong pats on the back of the child between the shoulder blades. Then, turn the child upside down to the right hand, if the child still has difficulty breathing, cyanosis, use two left fingers to press firmly in the area 1/2 below the sternum 5 times. If the object has not come out, turn the young person over and continue patting the back. Alternate back pats and chest compressions until the object falls out of the airway or the baby cries.

For older children (over 2 years old), do the Heimlich maneuver:
If the child is awake:
Stand or kneel behind, wrap your arms around the child Place a hand (fist) under the nose Place a table Hold the fist with the other hand. Press the abdomen strongly from front to back and from bottom to top 5 times Check the mouth for foreign bodies, if any If there is still obstruction, continue to press the abdomen as above.

In the case of a comatose or unconscious child:
Place the child on his or her back. The first aider kneels, resting his legs on both sides of the child's thighs. Squeeze your hands into fists, suddenly pressing under the child's breastbone. Press firmly from bottom to top 5 times in a row. Then check the airway. If the object has not fallen out, continue to repeat the above steps until the object falls out or the emergency team arrives.

Keep out of reach of small children all small objects that can be dangerous to children, especially round and slippery objects that easily fall into the airways. Do not force children to eat or drink while crying or play with food in their mouths. Teach children the habit of not putting objects and toys in their mouths. Do not let children eat easily choking foods such as peanuts, jelly, longan... To register for examination and treatment at Vinmec Times City International General Hospital, you can contact the hotline: 0243 9743 556, or sign up for registration. Register online HERE.