Foreign body aspiration in children: A review of prevention guidelines by analyzing choking episodes in Eastern Québec from 2006 to 2020

Abstract

BACKGROUND Many associations have published prevention guidelines to advise parents and health professionals about the risks of choking episodes and their complications. Yet, every year, many children are admitted following a choking episode that requires a bronchoscopy under general anesthesia. OBJECTIVES The objective was to identify the risks factors associated with choking episodes in children and compare them with actual prevention guidelines to determine if they are still adequate. METHODS This retrospective study included all patients, from 0 to 17 years old, who presented to the Center Mère-Enfant Soleil du CHU de Québec - Université Laval, between April 2006 and December 2020 and underwent a bronchoscopy under general anesthesia for a suspicion of foreign body aspiration. Data on demographic characteristics of the patients, the circumstances of the episodes and on severity criteria were collected and compared to the prevention guidelines. RESULTS Of the 101 patients included, 64.9% of them were boys with a mean age at presentation of 31.5 months. Food was the most common type of foreign body (73.3%) involving mostly nuts, seeds or raw vegetables. Choking episodes happened mostly at home (84.5%) and the majority (79.4%) happened under parental surveillance. A general increase in the number of admissions for choking episodes was noted. CONCLUSION Choking episodes requiring hospital admission were on the rise mostly due to a lack of adherence or knowledge of national prevention guidelines. These findings highlight the need for better parental education by addressing choking hazards during medical visits.