Aspiration of a Foreign Object

  1. General information
    1. Relatively common airway problem.
    2. Severity depends on object (e.g., pins, coins, nuts, buttons, parts of toys) aspirated and the degree of obstruction.
    3. Depending on object aspirated, symptoms will increase over hours or weeks.
    4. The curious toddler is most frequently affected.
    5. If object does not pass trachea immediately, respiratory distress will be evident.
    6. If object moves beyond tracheal region, it will pass into one of the main stem bronchi; symptoms will be vague, insidious.
    7. Causes 400 deaths per year in children under age 4.
  2. Medical management
    1. Objects in upper airway require immediate removal.
    2. Lower airway obstruction is less urgent (bronchoscopy or laryngoscopy).
  3. Assessment findings
    1. Sudden onset of coughing, dyspnea, wheezing, stridor, apnea (upper airway)
    2. Persistent or recurrent pneumonia, persistent croupy cough or wheeze
    3. Object not always visible on x-ray
    4. Secondary infection
  4. Nursing interventions
    1. Perform Heimlich maneuver if indicated.
    2. Reassure the scared toddler.
    3. After removal, place child in high-humidity environment and treat secondary infection if applicable.
    4. Counsel parents regarding age-appropriate behavior and safety precautions.




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