3 Choking children – should we be scared?

Abstract

Aim Choking in children is a feared condition, which potentially can deteriorate to hypoxic cardiac arrest and death. Fast recognition and immediate initiation of basic life support (BLS)1, primary back blows and abdominal thrusts given by bystanders and secondary activation of the Emergency Medical System (EMS) are vital for the survival. Methods The Region of Southern Denmark has a tiered response with prehospital emergency physicians to supplement the ambulance service. EMS physicians register all contacts in a database. We reviewed the database for all children below the age of 5 years who suffered from choking in 2009 to 2014. Results From 70.289 total contacts 4.857 contacts was with children less than 5 years. In this group 98 children suffered from choking. In 78% BLS had resolved the obstructing foreign body before arrival of EMS services. Seventeen children had successful treatment with BLS by ambulance personal. Five children required advanced airway management and one child required cardiopulmonary resuscitation. No deaths were registered. None of the children with near fatal choking had any comorbidity prior to incident. Conclusion Choking in children is an uncommon emergency with only 0,14% of all contacts. We found like others2 that BLS solves most cases before arrival of EMS. This demonstrates the importance of immediate initiation of BLS and keeping the chain of survival as a concept. Death to choking is rare among small children. Near fatal choking resolves with skills and routine in advanced airway management and advanced life support. References Maconochie IK, Bingham R, Eich C, Lopez-Herce J4, Rodriguez-Nunez A, Rajka T, Van de Voorde P, Zideman DA, Biarent D: European Resuscitation Council Guidelines for Resuscitation 2015: Section 6. Paediatric life support. Resuscitation. 2015Oct;95:223–48. Vilke GM, Smith AM, Ray LU, Steen PJ, Murrin PA, Chan TC: Airway obstruction in children aged less than 5 years: the prehospital experience. Prehosp Emerg Care2004, 8:196–199. Conflict of interest None declared. Funding None declared.