Choking prevention

Issue: BCMJ, Vol. 49, No. 9, November 2007, page(s) 504 Pulsimeter
.P. Ludemann, MDCM, FRCSC , Navid Dehghani, MD, FRCPC

As part of a Choking Prevention and Quality Improvement Initiative, we would like to inform physicians that:

• Any patient who presents with coughing and/or wheezing after oral exposure to a high-risk object (such as a nut or nut fragment, piece of raw carrot, apple or pear, unpopped popcorn kernel, seed, dried bean, plastic toy part, thumbtack, or pin) should be considered to have a bronchial foreign body until proven otherwise.

• For patients with a round metallic disc in the esophagus, a disc battery must be urgently ruled out.

• To prevent complete laryngeal obstruction, hotdogs and grapes should be cut lengthwise into quarter sections until a child is at least 5 years old and has no development delay in terms of swallowing. Deflated balloons and gel candies (a.k.a. “fruit poppers;” available in many Asian markets) should be kept out of reach of young children. Please advise parents of these issues.

For more information, please refer to the BC Children’s Hospital Clinical Practice Guidelines for Bronchial and Esophageal Foreign Bodies.