Guidelines for correct treatment of foreign objects stuck in the throat of children

Author: Yan Shang, attending physician at Shenzhen Children's Hospital, PhD

Reviewer: Pan Hongguang, Chief Physician, Shenzhen Children's Hospital

Foreign objects stuck in the throat are actually very common in daily life, especially among active and curious young children. So how should we deal with this situation correctly? Is the Heimlich maneuver that we often hear about really applicable to all cases of foreign objects stuck in the throat?

This article will provide you with a detailed introduction to the common locations of foreign objects stuck in the throat, symptom differentiation, first aid measures and prevention methods, helping parents master scientific handling methods at critical moments.

1. Common locations and symptoms of foreign bodies stuck in the throat

Foreign bodies stuck in the throat usually occur in three main parts: the pharynx, esophagus and trachea. Different types of foreign bodies stuck in different parts have different symptoms. Understanding these differences can help parents accurately determine the problem and take the right measures.

1. Foreign body in the pharynx

The pharynx is the most common site of throat obstruction, typically a fish bone. Common symptoms include dysphagia, a foreign body sensation in the throat, and drooling due to the child's unwillingness to swallow saliva.

How to determine whether the foreign body is in the pharynx?

The pain is usually localized above the suprasternal fossa, especially in the throat.

Most foreign bodies in the pharynx are stuck in the bilateral tonsils or the root of the tongue. The symptoms are local tingling and can be easily seen through oral examination.

Figure 1 Copyright image, no permission to reprint

2. Foreign bodies in the esophagus

Foreign bodies in the esophagus are usually large, lumpy foreign bodies, such as coins, chicken bones, etc. There are three physiological narrow areas in the esophagus, and foreign bodies are easily stuck in these locations. Common symptoms include retrosternal pain (pain below the neck), dysphagia, and drooling.

How to determine whether a foreign body is in the esophagus?

The pain is located behind the sternum, and the child will refuse to eat and drool.

3. Foreign body in trachea

Foreign bodies in the trachea are the most dangerous and can easily lead to suffocation. They are more common in children aged 1 to 3 years old. Common foreign bodies include peanuts, melon seeds and other nuts. Symptoms include severe coughing and difficulty breathing, which may lead to suffocation in severe cases.

The clinical manifestations of tracheal foreign bodies can be divided into three stages:

Foreign body inhalation period: severe coughing, breath holding, possible suffocation.

Quiet period: The foreign body remains somewhere in the bronchus, the symptoms are relieved, but the foreign body is not expelled.

Obstruction period: Foreign bodies may cause complications such as bronchitis and pneumonia, with symptoms such as fever, cough, and difficulty breathing.

2. What to do when a foreign object gets stuck in your throat

1. Foreign body in the pharynx

If a fish bone gets stuck in the throat, avoid swallowing hard food or picking out the bone with your hands. Communicate with your child, and after the child opens his mouth to cooperate, press the child's tongue with the handle of a spoon. Observe the bilateral tonsils, tongue root and other parts under the illumination of a flashlight to see if there is a fish bone stuck. If the fish bone can be clearly seen, use tweezers or chopsticks to remove the fish bone. If the fish bone cannot be removed or cannot be found, go to the hospital as soon as possible.

Figure 2 Copyright image, no permission to reprint

2. Foreign bodies in the esophagus

Because the foreign body is located deep in the heart and near its large blood vessels, and its anatomical location is very important, parents cannot remove the foreign body by themselves. Just like foreign bodies in the pharynx, it is best not to try to swallow the foreign body with large pieces of food. Drinking vinegar or scratching the throat are also useless. If you suspect that it is a foreign body in the esophagus, you should go to the hospital as soon as possible.

Figure 3 Copyright image, no permission to reprint

Tracheal foreign body

If a child suddenly develops severe coughing and difficulty breathing, the Heimlich maneuver can be tried if it is confirmed that the foreign body has just been inhaled. However, after entering the quiet period, try to comfort the child, reduce crying, avoid activities, do not pat the back, and go to the hospital immediately.

Figure 4 Copyright image, no permission to reprint

3. How to prevent foreign objects from getting stuck in children’s throats?

1. Choose safe food

Young children should avoid eating fish with bones, and nuts should be ground into powder or boiled and crushed before eating.

Chew slowly

Cultivate the habit of chewing slowly in children and avoid swallowing large pieces of food.

Safe Environment

Try not to keep small objects that can be accidentally swallowed, such as coins and button batteries, in your home to prevent children from putting these items in their mouths.

Good eating habits

Children should sit upright when eating and avoid eating while running or crying.

4. How to correctly implement the Heimlich maneuver?

The Heimlich maneuver is an effective first aid measure, especially in the stage of tracheal foreign body inhalation, which can save lives. It is very important for parents to master this first aid skill. However, the Heimlich maneuver is different for children under 1 year old and those over 1 year old. Parents should master the key points of the maneuver for different age groups. The following are the steps of the Heimlich maneuver for children:

First determine whether the child needs emergency treatment: If the child has severe choking, is unable to speak, or has difficulty breathing, it may be that the trachea is blocked by a foreign body and immediate action is required.

1. First aid steps for children under 1 year old

Children under 1 year old cannot use the adult version of the Heimlich maneuver because of their small bodies and fragile bones. Instead, they should perform the following two steps:

① Patting the back

Lay the child's body prone on the rescuer's forearm, with the head facing down, the body slightly tilted, and the head lower than the chest.

Support your child's head and neck with your hands to ensure their airway is open.

Use the heel of your other hand to tap the area between your child's shoulder blades five times with moderate but firm pressure.

②Chest tapping method

If back blows fail to dislodge the object, turn the child over so that he or she is lying face up on the rescuer's lap, with the head slightly lower than the torso.

Use two fingers (middle finger and index finger) to press down quickly 5 times about 1 finger width below the line connecting the two nipples on the child's chest.

Repeat the process of patting the back and chest until the foreign body is expelled or the child resumes normal breathing.

2. First aid procedures for children 1 year old and older

For children 1 year and older, the standard Heimlich maneuver can be used:

Have the child stand or sit in front of the rescuer.

The rescuer stands behind the child, makes a fist with one hand, and places the thumb side of the fist against the child's abdomen (above the navel and below the sternum).

With your other hand, make a fist and squeeze your child's abdomen inward and upward, giving quick, forceful pushes.

Repeat: Keep pushing until the foreign body is expelled or the child resumes normal breathing.

3. When to stop first aid

If the child starts to cry violently, cough or the foreign body is successfully expelled, the pushing should be stopped immediately. At this time, the child should be comforted and sent to the doctor as soon as possible to ensure that the airway is completely open.

It should be noted that the Heimlich maneuver is only applicable to emergency situations caused by foreign bodies in the trachea. If the child is only stuck in the pharynx or esophagus, blindly using this maneuver may cause more serious damage.

5. Protect children's health, starting from the details

Although foreign objects stuck in the throat are common, as long as we master the correct first aid knowledge and take effective preventive measures, we can greatly reduce the risk of suffocation caused by foreign objects stuck in the throat. In daily life, parents should always be vigilant, avoid letting children come into contact with objects that are easy to eat by mistake, and cultivate good eating habits for children. At critical moments, calm response and scientific handling can better protect the health and safety of children.