Need for more clear parental recommendations regarding foreign body aspiration in children.

INTRODUCTION Foreign body (FB) aspiration is a common cause of respiratory emergency in early childhood and is associated with a high rate of airway distress. FB aspiration peaks at the age of 1-2 years. Factors placing children at higher risk include incomplete dentition, immature swallowing coordination and the tendency to be easily distracted while eating. Symptoms may vary from an un-affected child to impending airway failure. Mucosal cough receptors often accommodate and the child may be asymptomatic when evaluated. MATERIAL AND METHODS Files of children (0-15 years) admitted with suspected FB aspiration were reviewed. Patients were included if the FB was confirmed by bronchoscopy. RESULTS Among 136 children undergoing bronchoscopy, a FB was confirmed in 59 patients. The median age was one year. All children had a history of aspiration and in 48% a persistent cough was present at the initial examination. Eleven children (19%) had a normal physical examination at admission. Nuts were identified in 34% and carrots in 20%. Of the FBs removed, 86% were organic and 14% were inorganic. Organic FBs were more common in patients younger than three years (p < 0.001). CONCLUSION Parental suspicion of FB aspiration indicates acute bronchoscopy in children, even in case of no abnormal findings. The completion of the bronchoscopy within 24 hours facilitates the examination and reduces the risk of complications. We recommend increased awareness of the hazards associated with small crunchy organic food items, especially nuts and carrots, given to children under three years of age. FUNDING not relevant. TRIAL REGISTRATION not relevant.