Foreign body aspiration in Israeli children during the COVID-19 pandemic

Background: Since the outbreak of the Coronavirus disease 2019 (COVID-19) pandemic, there has been a decline in pediatric emergency department visits. Our aim was to assess the pattern of pediatric foreign body aspiration (FBA) during the first year of the COVID-19, in comparison to the prior years. Methods: In this retrospective multicenter study, we compared the number of children that presented with FBA during the COVID-19 year (March 1st, 2020 to February 28, 2021), to the annual average of the years 2016-2019. We also compared the lockdown periods to the post-lockdown periods and the percentage of missed FBA, proven FBA, and flexible bronchoscopy as the removal procedure. Results: 345 children with FBA from six centers were included, 276 in the pre-COVID-19 years (average 69 per year) and 69 in the COVID-19 year. There was no difference in the prevalence of FBA between the COVID-19 year and any of the prior four years. Examining the lockdown effect, the monthly incidence of FBA dropped from a pre-COVID-19 average of 5.75 cases to 5.1 cases during lockdown periods and increased to 6.3 cases in post-lockdown periods. No difference in the percentage of missed FB or proven FB was observed. There was a significant rise in the usage of flexible bronchoscopy as the removal procedure (Average of 15.4% vs 30.4%, p=0.001) Conclusion: There was no difference in the prevalence of FBA during the COVID-19 year. However, there were fewer cases during lockdown periods, compared to post-lockdown periods, presumably related to better parental supervision.

Rigid Bronchoscopy in Foreign Body Aspiration Diagnosis and Treatment in Children

Foreign body aspiration in children is a common condition and can bring about serious undesired results. Fast and accurate diagnosis and foreign body extraction from airways are essential. We performed a retrospective study on rigid bronchoscopy outcomes due to suspected foreign body aspiration. A total of 66 children were admitted to the Chair and Department of Pediatric Otolaryngology, Phoniatrics and Audiology, Medical University of Lublin between 2015 and 2020 and underwent rigid bronchoscopy in general anesthesia due to suspected foreign body aspiration. We analyzed the data, including patients age and sex, reported complaints, and bronchoscopy findings. Analyzed children were aged from 8 months to 17 years old; 74.24% of them were under 3 years old during the procedure, and most of the operated patients were males. In 36.36% cases, no foreign body was identified, and 57.14% foreign bodies were located in right main bronchus. A total of 80.95% of foreign bodies extracted from airways were organic, mostly nuts. Diagnosis and treatment of suspected foreign body aspiration requires consistent cooperation between pediatricians, pulmonologists, anesthesiologists, and otolaryngologists.

Foreign Body Aspiration in Dentistry

Background: The foreign body aspiration is very common while performing a dental procedure. Most of the patients are from lower age group as these group of people have high amount of sugar and starch containing diet which is not good for the oral health. But it is not limited to them and several aged patients are also victim of foreign body aspiration. Summary: Foreign bodies can be anything from cloth dam, barrier techniques itself to broken tooth. Due to age related delayed gag reflex and impact of anesthesia can be possible reasons behind the foreign body aspiration. Pulmonary aspiration is a serious cause of concern and cannot be neglected. It can go unnoticed which can brought to cognizance after careful study and observation of the radiographs. Endoscopic procedures are used to locate and extract the foreign body from the lungs. Conclusion: Proper guidelines regarding the extraction of foreign body extraction and identification must be followed as it is life threatening condition. Vulnerable age group must be treated with extra caution and every chance of mistake must be covered. Standard operating procedure must be strictly adhered to in order rot have maximum accuracy.

Effectiveness of Video Assisted Teaching programme on knowledge regarding first aid management of foreign body aspiration among mothers of under-five children

Foreign body aspiration remains a significant cause of death in children for anatomic as well as developmental reasons. Foreign body aspiration is a potentially life-threatening event because it can block respiration by obstructing the airway, there by impairing oxygenation and ventilation. Mothers, as a primary care giver must be aware of first aid management of foreign body aspiration and measures to prevent it. Hence, the study was undertaken to assess the effectiveness of video assisted teaching programme on knowledge regarding first aid management of foreign body aspiration among mothers of under-five children in selected anganwadis under Nadathara Gramapanchayath, Thrissur. The other objectives of the study were to find out the association between level of knowledge with selected demographic variables of mothers regarding first aid management of foreign body aspiration. Quasi experimental one group pre testpost test design was conducted among 30 mothers of underfive children. Samples were selected by using purposive sampling method from 2 anganwadis. Pre test was conducted using structured knowledge questionnaire. It was followed by video assisted teaching of first aid management of foreign body aspiration with appropriate AV aids by the investigator. Post test was done after 7 days and the analysis shows that there is a significant increase in knowledge score of mothers regarding first aid management of foreign body aspiration. Also, the study findings revealed that there is no association between knowledge score of mothers with their selected demographic variables. Thus, the study concluded that the video assisted teaching regarding first aid management of foreign body aspiration was effective in improving the knowledge of mothers.

A Case of Whistle as Foreign Body in Trachea

Background. Most of foreign body aspiration cases are found in children under the age of fifteen. Pediatric patients often presents with non-food foreign body aspiration, such as toys. The most common clinical manifestation are history of choking following foreign object insertion into the mouth (85%), paroxysmal cough (59%), wheezing (57%) and airway obstruction (5%). Case presentation. Main principle of airway foreign body extraction is to do it immediately in the most optimal condition with slightest possible trauma. Rigid bronchoscopy is a suitable choice for tracheal foreign body extraction. We reported a case of seven years old male with tracheal foreign body presented with history of whistle ingestion five hours prior to admission. This patient was discharged from hospital after third days of rigid bronchoscopy procedure. Conclusion. History of foreign body aspiration in children should be suspected as a tracheobronchial foreign body. Rigid bronchoscopy is preferred to extract foreign bodies present in the trachea. The prognosis for tracheobronchial foreign body aspiration is good if the foreign body is treated early and without complications.

Clinical and imaging interrelationships in the diagnosis of foreign body aspiration in children

Background: Foreign body aspiration (FBA) is a typical occurrence in children. The clinical signs are influenced by various causes, and the differential diagnosis is important, especially when the suffocation crisis is not recognized. The aim of this study was to evaluate the clinical and imaging symptoms in children with FBA. Material and methods: A retrospective study is provided of 156 children who were hospitalized and examined (clinical and paraclinical tests) in the Pneumology Clinic between 2011 and 2020 after having a foreign body removed from their airways, using rigid tube bronchoscopy or fibrobronchoscopy. Results: The most affected age group was 1-3 years, which constituted 77.6% (95% CI 70.2% -83.8%). The most common symptoms were: cough – 98.7% (95% CI 95.4%-99.8%), dyspnoea – 94.2% (95% CI 89.3%-97.3%), wheezing – 61.5% (95% CI 53.4%-69.2%). Chest radiography was relevant for foreign body aspirations in 55.8% of cases (95% CI 47.6%-63.7%). The foreign body was extracted from the right bronchus in 32.1%, from the left bronchus in 21.8% of cases, from the lobar / segmental bronchi – 22.5%, and in 21.2% – multiple locations. The etiological structure of the endobronchial foreign body was dominated by the organic ones – 96.8%. Conclusions: Cough, dyspnoea, and wheezing are suggestive of this pediatric emergency. Chest radiography provides diagnostic information only for every second child.