Foreign body in the respiratory passages
A child with obvious breathing difficulties and a suspicion of a foreign body in the respiratory passages should first be hanged down from the legs and tapped forcefully on the back with the palm. Try Heimlich's manoeuvre. If hanging down from the legs and tapping prove unsuccessful, laryngoscopy or bronchoscopy is recommended. If the upper airway has been blocked, e.g., by facial trauma and intubation is unsuccessful, the trachea can be cannulated with a thick needle just below the thyroid cartilage. This method is easier and quicker than emergency tracheostomy. An acute coughing spell with accompanying symptoms in a child of a high risk age should be considered a suspected aspiration. The final diagnosis is based on bronchoscopy. Mouth-to-mouth respiration should always be tried after unsuccessful attempts to remove a foreign body, as increased pressure in the respiratory passages may lead air past the foreign body.
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