This document outlines the approach to choking in children and adults. It discusses that choking is a leading cause of morbidity and mortality in children under 4 years old, with foods like nuts and seeds being common choking hazards. It describes the risk factors, pathophysiology, clinical features, and emergency management of choking. Prevention strategies are also covered, such as educating caregivers and avoiding small, round objects that can easily get lodged in the airway.

1. APPROACH TO CHOKING
CHILD/ADULT
DR. BERTHA VOLEMATOME GIBIL
PEDIATRIC SPECIALIST

2. Outline
 Objectives
 Introduction
 Risk factors
 Pathophysiology
 Clinical features
 Management
 Prevention
 Conclusion

3. Objectives
 To recognize a choking child
 Identify risk factors
 Emergency management of choking child

4. Introduction
 Leading cause of morbidity and mortality in children <4yrs
 Common objects
 Food items eg. Nuts , seeds (59.5%-81% of cases of choking)
 Inorganic objects eg coins, button batteries, toys,pins
 Round object are esp hazardous(ability to occlude airway)
 1.7times commoner in males than females

5. Why children are prone to FB aspiration
 Curious and explore
 Distracted whiles eating
 Improper mastication
 Underdeveloped swallowing, fuction of larynx not fully developed
 Smaller airway diameter
 Ineffective cough

6. Risk factors
 Developmental delays/disorders with neurological/muscular problem
 Older children with psychiatric disorders
 Post natal period
 Prematurity
 Tracheo-esophageal fistula
 Improper feeding practices

7. Pathophysiology
 FB end up on either right or left bronchus in children <15yrs
 Right bronchus steeper making it easy to lodge on the right (>15yrs)
 Migration and position change
 Fragmentation of FB
 Unsuccessful attempts with removal
 Hydroscopic FB may absorb water
 Inflammation and edema

8. Clinical features
 Asymptomatic to severe respiratory distress =>complete airway obstruction =>asphyxia => death
 3 stages of symptom progression
 Initial events ; paroxysms of cough, chocking gagging
 Asymptomatic interval; FB becomes lodged, reflex fatique+ irritating symptoms subside
 Complication ; erosion, infections, pneumonia, atelectasis

9. Emergency management In responsive patient
Assess
airway
Assess
breathing
adequacy
5 back
blows
5 chest
thrust
Reassess

10. Emergency management in child/adult
Assess
airway
Assess
breathing
adequacy
5
Abdominal
thrust
5 Back
blows
Reassess

11. Emergency management in uncoscious victim
Check mouth
Open airway
5 rescue
breaths
5 Chest thrust
5 Back blows
If no response
start BLS
algorithm

12. COMPLICATIONS OF LONG STANDING FB
 Ulceration
 Tracheoseophageal fistula
 Mediastinits
 Erosion into a major vessel (aortoenteric fistula)
 stricture

13. PREVENTIVE MEASURES
 Discourage Speaking whilst eating
 Nuts should be slowly introduced to the diets of children after age 3
 Implicated objects should be used only under adult supervision
 Keep disc bateries away from the reach of children
 Education of caregivers about providing foods of appropriate size and texture
 Train caregivers in the methods of clearing the airway ie, Heimlich manuevre, finger sweep

14. CONCLUSION
 Those in nyouger age groups more at risk
 Coins most common ingested FB
 Smaller size objects occur in the much younger age grps and lodge more distally
 Caregiver education on preventive measures and prompt reporting to hospital in event of FB
ingestion / aspiration
 Peripheral facilities to promptly refer for FB removal to avert some of the complications

15. THANK YOU

16. REFERENCES
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Anyomih, "Foreign Body Aspiration in Northern Ghana: A Review of Pediatric Patients", International
Journal of Otolaryngology, vol. 2017, Article
ID 1478795, 4pages, 2017. https://doi.org/10.1155/2017/1478795
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