Foreign Body Aspiration in Children

Foreign body aspiration (FBA) is an important cause of morbidity and mortality in pediatrics. Most cases occur in children younger than 3 years, and the classic triad of choking, cough, and unilateral wheezing or decreased air entry is seen in only a minority of patients. Oftentimes, the diagnosis can be challenging when an aspiration event is not directly witnessed. Management depends on the acuity of the presentation. Patients with evidence of complete upper airway obstruction should have age-appropriate basic life support maneuvers performed. Patients with partial obstruction who are able to maintain their airway but with potential for deterioration should be taken immediately to the operating room for removal whenever possible. Stable patients may have radiographic studies performed to assist in risk stratification. Patients in whom suspicion for FBA is high should undergo bronchoscopy, whereas a subset of low-risk patients may be observed. Delays in diagnosis increase the risk of complications.