Swallowing objects

Pediatrician Alan Nagar, MD, MHA, Emergency Medicine, Children's Hospital Los Angeles, shares advice for parents on what to do when your child swallows an object and the signs that you should go to the hospital
Pediatric First Aid - Child Swallows An Object
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Swallowing objects

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Kids are mischievous and young children frequently swallow objects, take them into their mouths, choke. There is a gamut of signs and symptoms. Swallowing an object and the care required really depends upon a number of things. The substance, was it plastic, was it glass, was it a battery, was it a coin? The treatment for some of those varies. For instance, if a child swallows a battery, that's a medical emergency because the battery can actually erode through the esophagus. We see a number of patients who swallow plastic and suck it into their lungs. In other words, suck it down their airway or their trachea. That, likewise, is a medical emergency because it needs to be removed. The other entity that we see is the parent who says, "My child was playing in a room and there were toys around. I heard him choke. When I came in they were choking and drooling. I don't know if they swallowed something or spit it out because I couldn't find anything." Those are the ones that can be more challenging for us because x-rays sometimes show an object if it's metal or some forms of glass, but if it's plastic or rubber, that foreign body can be somewhere in the intestines and non-visible on the x-ray. That's when we need to do some decision making like, will it pass or do we need to perform any kind of intervention. So it goes like this; if we think the child has sucked something into his lungs, the child undergoes what's called bronchoscopy. The surgeon has to look inside the airways of the lungs, and sometimes they find something, and sometimes they don't. Most objects that are swallowed or get stuck in the esophagus or food pipe, go on and pass on through. Interestingly enough, glass usually goes through easily. Small objects, coins, and even stick pins usually pass right through. Although a child swallowing an object is somewhat scary to the parent, if it goes through the esophagus, it's not usually much of a problem. The issue is deciding, does the child have an object in their lungs or the supporting airway structures to the lungs, and that becomes a more significant medical emergency.

Pediatrician Alan Nagar, MD, MHA, Emergency Medicine, Children's Hospital Los Angeles, shares advice for parents on what to do when your child swallows an object and the signs that you should go to the hospital

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Alan Nager, MD, MHA

Pediatrician, Emergency Medicine, Children’s Hospital Los Angeles

Dr. Alan Nager is Head of the Division of Emergency and Transport Medicine at Children’s Hospital Los Angeles. He is an Associate Professor of Pediatrics at the Keck School of Medicine at the University of Southern California. Dr. Nager received his undergraduate degree in Public Heath and Child Psychology, his graduate degree in Healthcare Administration, his medical degree from the University of Minnesota Medical School and his training in Pediatric Emergency Medicine at the Children’s Hospital of Pittsburgh.  He has lectured extensively on a variety of emergency medicine topics, appeared numerous times in the media, and published extensively on topics such as dehydration, trauma, mental health, disaster preparedness, etc. He has also authored a children’s book entitled, Angels in Action: One Day in the Emergency Department.

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Transcription: 
Kids are mischievous and young children frequently swallow objects, take them into their mouths, choke. There is a gamut of signs and symptoms. Swallowing an object and the care required really depends upon a number of things. The substance, was it plastic, was it glass, was it a battery, was it a coin? The treatment for some of those varies. For instance, if a child swallows a battery, that's a medical emergency because the battery can actually erode through the esophagus. We see a number of patients who swallow plastic and suck it into their lungs. In other words, suck it down their airway or their trachea. That, likewise, is a medical emergency because it needs to be removed. The other entity that we see is the parent who says, "My child was playing in a room and there were toys around. I heard him choke. When I came in they were choking and drooling. I don't know if they swallowed something or spit it out because I couldn't find anything." Those are the ones that can be more challenging for us because x-rays sometimes show an object if it's metal or some forms of glass, but if it's plastic or rubber, that foreign body can be somewhere in the intestines and non-visible on the x-ray. That's when we need to do some decision making like, will it pass or do we need to perform any kind of intervention. So it goes like this; if we think the child has sucked something into his lungs, the child undergoes what's called bronchoscopy. The surgeon has to look inside the airways of the lungs, and sometimes they find something, and sometimes they don't. Most objects that are swallowed or get stuck in the esophagus or food pipe, go on and pass on through. Interestingly enough, glass usually goes through easily. Small objects, coins, and even stick pins usually pass right through. Although a child swallowing an object is somewhat scary to the parent, if it goes through the esophagus, it's not usually much of a problem. The issue is deciding, does the child have an object in their lungs or the supporting airway structures to the lungs, and that becomes a more significant medical emergency.