Summary about Disease
Foreign body aspiration (FBA) occurs when an object is inhaled into the airway, lodging in the larynx, trachea, or bronchi. This can partially or completely obstruct the airway, leading to respiratory distress or, in severe cases, death. It is most common in young children, particularly those under the age of 3, but can occur at any age.
Symptoms
Symptoms of FBA vary depending on the size and location of the object, and the degree of airway obstruction. Common symptoms include:
Sudden onset of coughing, choking, or gagging
Wheezing
Stridor (a high-pitched whistling sound during breathing)
Difficulty breathing or shortness of breath
Cyanosis (bluish discoloration of the skin due to lack of oxygen)
Hoarseness
Drooling
Inability to speak
Loss of consciousness (in severe cases)
Recurrent pneumonia
Causes
The most common cause of FBA is accidental inhalation of small objects. Common culprits include:
Food (e.g., nuts, seeds, grapes, popcorn, hard candy)
Small toys (e.g., buttons, beads, small parts of toys)
Coins
Balloons
Plant material
Dentures (in older adults) Risk factors include:
Young age (especially infants and toddlers)
Improper chewing or swallowing
Distraction while eating
Neurological or developmental conditions that impair swallowing
Poor dentition (in older adults)
Medicine Used
While not a direct "medicine," inhaled bronchodilators (like albuterol) may be administered *after* the foreign body is removed if the aspiration caused bronchospasm (constriction of the airways). Antibiotics may be used to treat pneumonia, which can develop as a complication of FBA. The primary treatment is the removal of the foreign body via procedures like bronchoscopy. No specific medications can remove the foreign body.
Is Communicable
Foreign body aspiration is not communicable. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Preventing FBA is crucial, especially in children. Precautions include:
Keep small objects out of reach of young children.
Supervise young children while they are eating.
Cut food into small, manageable pieces.
Avoid giving young children foods that are high-risk for aspiration (e.g., whole nuts, grapes, popcorn, hard candy).
Encourage children to sit down while eating and avoid running or playing with food in their mouths.
Teach children not to put objects in their mouths.
Ensure that toys are age-appropriate and do not have small, detachable parts.
Educate caregivers on how to perform the Heimlich maneuver.
For adults, ensure proper fitting dentures and address any swallowing difficulties promptly.
How long does an outbreak last?
Because FBA is not communicable, it does not occur in "outbreaks". The consequences of the event last until proper medical intervention occurs and potentially longer if complications arise.
How is it diagnosed?
Diagnosis of FBA typically involves:
History and Physical Examination: A detailed history of the event, including the sudden onset of coughing, choking, or breathing difficulties, is crucial. Physical examination may reveal signs of respiratory distress, such as wheezing, stridor, or cyanosis.
Imaging Studies: Chest X-rays can sometimes visualize radiopaque (visible on X-ray) foreign bodies. However, many aspirated objects are radiolucent (not visible on X-ray). Specialized X-ray techniques, such as fluoroscopy, may be used.
Bronchoscopy: This is the most definitive diagnostic and therapeutic procedure. A flexible or rigid bronchoscope (a thin, lighted tube with a camera) is inserted into the airway to visualize the larynx, trachea, and bronchi. Bronchoscopy allows for direct visualization of the foreign body and its removal.
Timeline of Symptoms
The timeline of symptoms can vary significantly.
Immediate: Sudden onset of coughing, choking, gagging, or difficulty breathing.
Within Minutes: Wheezing, stridor, cyanosis.
Within Hours: If the object is not completely obstructing the airway, symptoms may be intermittent or less severe. Hoarseness or drooling may develop.
Days to Weeks (if undiagnosed): Recurrent pneumonia, persistent cough, wheezing, or unexplained respiratory symptoms. Chronic inflammation can occur.
Important Considerations
Time is critical: Prompt diagnosis and removal of the foreign body are essential to prevent serious complications.
Heimlich maneuver: Caregivers should be trained in performing the Heimlich maneuver for both children and adults.
Complications: Potential complications of FBA include pneumonia, lung abscess, bronchiectasis (permanent widening of the airways), and respiratory failure.
Silent aspiration: In some cases, FBA may be silent, with no immediate symptoms. This is more common with smaller objects or partial airway obstructions.
Anesthesia: Bronchoscopy is usually performed under general anesthesia, especially in children.
Post-Procedure Care: After removal of the foreign body, monitoring for complications such as swelling of the airway or pneumonia is necessary.