Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Key Features ++ Sudden onset of coughing or respiratory distress Difficulty vocalizing Children 6 months to 4 years are at the highest risk Without treatment, progressive cyanosis, loss of consciousness, seizures, bradycardia, and cardiopulmonary arrest can follow +++ Clinical Findings ++ Coughing, choking, or wheezing Onset is generally abrupt Complete obstruction indicated by acute onset of choking along with inability to vocalize or cough and cyanosis with marked distress Partial obstruction indicated by drooling, stridor, and ability to vocalize +++ Diagnosis ++ Chest radiography and other imaging studies have been used to evaluate for foreign body ingestion However, rigid bronchoscopy is diagnostic gold standard +++ Treatment ++ If complete obstruction is present, immediate intervention is necessary If partial obstruction is present, then the choking patient should be allowed to use his or her own cough reflex to remove the foreign body If child is awake and younger than 1 year with a complete obstruction, Place the child face down over the rescuer's arm Deliver five measured back blows rapidly followed by rolling the infant over and delivering 5 rapid chest thrusts Sequence is repeated until the obstruction is relieved In a choking child older than 1 year, abdominal thrusts (Heimlich maneuver) should be performed If the child of any age becomes unresponsive, cardiopulmonary resuscitation is recommended; chest compressions may help dislodge the foreign body Blind finger sweeps should not be performed in infants or children because the finger may push the foreign body further into the airway The airway may be opened by jaw thrust, and if the foreign body can be directly visualized, careful removal with the fingers or instruments should be attempted Patients with persistent apnea and inability to achieve adequate ventilation may require emergency intubation, tracheotomy, or needle cricothyrotomy Foreign body removal is most successfully performed using rigid bronchoscope under general anaesthesia Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth