If a crumb gets into the child's lungs. View full version

The topic of this article is not seasonal. But it is very relevant for everyone who has small children. However, similar troubles also happen to adults. I mean the entry of a foreign body into the respiratory tract.

Let's talk briefly about adults first. How can a foreign body get into the respiratory tract of an adult? After all, he doesn’t put everything in his mouth like children. Of course it doesn't drag. But some adults have the habit of holding some small objects in their teeth while working. Remember, haven’t you ever had pins or small nails or screws in your mouth? By the way, I often do this myself. Foreign bodies such as dentures can enter an adult's airway during sleep or in situations where the person is unconscious. And of course, don’t forget that you can simply choke on food.

According to statistics, in 95-98% of cases, foreign bodies in the respiratory tract occur in children aged 1.5 to 3 years.

Children are little explorers. Their area of research includes absolutely everything. And they want not only to see, hear and touch their surroundings, but to taste everything they can reach. And these hands don’t always reach only for toys. Often these are completely inappropriate items, for example, beads, buttons, beans or peas, nuts, and so on. Children try to apply small objects to everything and most often push them into the most inappropriate places. And such inappropriate places include the ears, nose and mouth. Some small object that the child put in his mouth “slips” into the larynx during a deep breath. The reason for such inhalation may be fear, crying, screaming.

In addition, a child of this age is just learning to chew and swallow solid food correctly. And, of course, he doesn’t succeed right away. Therefore, it is at this age that the risk of pieces of solid food getting into the respiratory tract is greatest.

Another bad thing is that the child cannot always say what exactly happened to him. And sometimes foreign bodies in the respiratory tract are detected too late.

And now a little anatomy.

The structure of the respiratory tract in humans is as follows: when inhaling, air enters the nasal passages, then into the nasopharynx and oropharynx (here the respiratory system intersects with the digestive system). Then - the larynx. In the larynx, air passes through the vocal cords and then into the trachea. Here is the first feature: in the subglottic space in a child under 3-5 years of age, lymphoid tissue is strongly expressed, which has a tendency to rapid swelling. This is what leads to the development of false croup during viral infections. And when foreign bodies enter this area, swelling of the subglottic space also very quickly develops, narrowing the airways. At the level of the 4-5 thoracic vertebrae, the trachea is divided into two main bronchi - the right and left, through which air flows to the right and left lungs, respectively. Here is the second feature: the right main bronchus is, as it were, a continuation of the trachea, extending to the side at an angle of only 25-30 degrees, while the left one extends at an angle of 45-60 degrees. That is why most often foreign bodies in the respiratory tract enter the generation of the right main bronchus. The right main bronchus is divided into three bronchi: the upper, middle and lower lobe bronchi. The left main bronchus is divided into two bronchi: the upper and lower lobe. Most often, foreign bodies end up in the right lower lobe bronchus.

According to the mechanism of obstruction (resistance to normal operation) of the respiratory tract, foreign bodies are divided into:

* non-obstructive lumen. Air passes freely past the foreign body during inhalation and exhalation. * completely obstructing the lumen. The air doesn't get through at all. * obstructing the lumen like a “valve”. On inhalation, air passes past the foreign body into the lung, and on exhalation, the foreign body blocks the lumen, thereby preventing air from leaving the lung.

Foreign bodies also differ in the method of fixation.

A fixed foreign body sits firmly in the lumen of the bronchus and practically does not move during breathing.

A floating foreign body is not fixed in the lumen and during breathing can move from one part of the respiratory system to another. Its movement can be heard with a phonendoscope in the form of “popping” when breathing. Sometimes it can be heard even from a distance. In addition, a floating foreign body is also dangerous because when it hits the vocal cords from below, a persistent laryngospasm occurs, which in itself leads to an almost complete closure of the lumen of the larynx.

Foreign bodies can enter any part of the respiratory tract. But in terms of localization, the most dangerous place is the larynx and trachea. Foreign bodies in this area can completely block the air supply. If immediate assistance is not provided, death occurs within 1-2 minutes.

For young children, the most dangerous situation is when a foreign body gets stuck between the folds of the glottis. The child cannot make a single sound. This is explained by the fact that a spasm of the glottis occurs, which can lead to respiratory arrest and suffocation. The child develops cyanosis (blue discoloration) of the mucous membranes and facial skin.

The fact that an adult or child is choking becomes clear from a sudden cough. At the same time, the person’s face turns red and tears appear in his eyes. And those around you readily hit you on the back with their fists. More often, of course, the crumb that got into the “wrong throat” is removed with a cough. But what if it’s not a crumb, but, say, a piece of sausage, an apple, or a fruit seed? Then, with each blow of a fist on the back, this piece will move further into the respiratory tract. In this case, normal breathing will change to stridorous breathing, that is, breathing with a characteristic wheeze during inspiration and with the participation of the muscles of the face, neck and chest. But not only does the piece block the air supply. It also irritates the mucous membrane of the larynx or trachea, and this, in turn, leads to their swelling and abundant secretion and accumulation of mucus. If the foreign body also has sharp edges, such as a plum pit, then it injures the mucous membrane and blood is added to the mucus. The victim’s condition is getting worse right before our eyes. The face, red at first, turns blue, the veins in the neck swell, a wheezing sound is heard when inhaling, and the depression of the supra- and subclavian fossae is visible. Coughing movements become less and less frequent, and movements become more and more sluggish. And very quickly the person loses consciousness. This condition is called blue asphyxia.

If the victim is not quickly given help, then blue asphyxia will turn into the stage of pale asphyxia in a few minutes. The skin will become pale with a grayish tint, the reaction of the pupils to light and the pulse in the carotid artery will disappear. In other words, clinical death will occur.

How to provide first aid in such a situation?

Firstly, you should not waste time examining the oral cavity. Secondly, do not try to reach the foreign body with your fingers or tweezers. If it is a piece of food, sausage or an apple, for example, then under the influence of saliva it will soften so much that when you try to get it out, it will simply fall apart into smaller pieces. And one or more of these small pieces, when inhaled, will again enter the respiratory tract.

But, no matter what the victim chokes on, the first thing to do is turn him over on his stomach and throw him over the back of a chair, if he is an adult, or over his own thigh, if he is a child. Then you need to hit him several times with an open palm on the back between the shoulder blades. You cannot strike with a fist or the edge of your palm.

If a small child chokes on a ball or pea, you need to quickly turn him upside down and tap him several times on the back at the level of the shoulder blades with an open palm. In this case, the “Pinocchio effect” will work. It will look the same as in the fairy tale about Pinocchio, when money was shaken out of him. If, after several strikes with your palm, the foreign body does not fall to the floor, then another method should be used.

But if a child chokes on a coin-shaped object, for example, a button, then another method must be used, since the one described above will not justify itself in this case, since the “piggy bank effect” is triggered. If you had a piggy bank as a child, remember how you tried to shake coins out of it. There is enough noise and ringing, but the coins do not want to fall out of the piggy bank, because they cannot stand on their own edge and roll around flat on themselves. This is how a flat and coin-shaped foreign body blocks the airways. We need to force him to change his position. To do this, you should use the method of shaking the chest. As a result of the shock, the foreign body will either rotate around its axis and open a passage for air, or move down the trachea and eventually end up in one of the bronchi. This will give the victim the opportunity to breathe with at least one lung.

There are several ways to shake the chest. The most common and effective of them is short, frequent blows with an open palm on the back in the interscapular area.

There is another method, which in Russia is called the “American police method.” I’ll say right away that I don’t know why it’s called that. In America this technique is called the Heimlich method. This method has two options.

First option

You need to stand behind the choking person, take him by the shoulders and pull him away from you at arm's length. Then sharply and forcefully hit his back against his own chest. This blow can be repeated several times. This option has one drawback. The chest against which the victim must be hit must be flat and masculine.

Second option

When using this option, you must also stand behind the victim. But in this case, you need to grab it with your hands so that your folded hands are below the victim’s xiphoid process. Then, with a sharp movement, you need to press hard on the diaphragm and at the same time hit the victim against your chest.

Both of these methods can be used if the victim is conscious. But at the same time, one must be prepared for the fact that the victim will develop a state of clinical death. Therefore, immediately after the blow, you should not unclench your hands, so as to prevent the victim from falling in case of cardiac arrest.

The same method, when applied to small children, should be performed as follows:

1. Place the baby on a hard surface on his back, tilt his head back, lift his chin; 2. Place two fingers of one hand on the child’s upper abdomen, between the xiphoid process and the navel, and quickly press deep and upward. The movement must be strong enough to remove the foreign object; 3. If the first time is not enough, then repeat the procedure up to four times.

Help for older children:

If blows to the back do not help, then sit the child on your lap, placing one of your hands on his stomach. Clench this hand into a fist, resting the inner side where the thumb is located in the middle of his stomach, and with the other hand hold the child behind his back. Quickly press your fist into your stomach a little upward and as deep as possible. The movement must be strong to dislodge the stuck object. Repeat pressing up to four times.

If the person who has choked has fallen into a coma, you must immediately turn him over onto his right side and hit him on the back with your palm several times. But, unfortunately, as a rule, these actions do not bring success.

Until next time!

Anyone can choke on food or water. That is why you should know the main principles of helping the victim. You can often hear the phrase: “Water went down the wrong throat.” What does this mean, and if this happened, how to deal with it?

Causes and symptoms

Why is this possible? The fact is that people carelessly and sometimes irresponsibly take the advice of experts: drink and eat slowly, do not talk at this time, chew food thoroughly. Such disregard for simple rules can cost your health, and in some cases, lead to a tragic outcome: food ends up in the “wrong place” and moves down a different path intended for air.

Elderly people who, due to their anatomical capabilities (lack of teeth or incorrectly selected dentures), cannot chew food well.
Children under 6 years old.
Patients with injuries or anatomical pathologies that may affect the swallowing process (for example, cleft lip).

A person who chokes on saliva or a sip of water will definitely start coughing. This is a great way to clear the airways of fluid that has entered there. Most often, such people do not require outside help. But if a solid foreign body (seed, apple or berry pits, bread crumbs) gets into the wrong throat, breathing is blocked partially or completely, and the person begins to choke. The face changes color to pale or, conversely, burgundy.

It is important that the choking person does not panic, since in this case attempts to inhale air become more frequent, which can lead to pushing an unnecessary object deeper into the trachea or lungs. Also, you should not “help” the patient by randomly tapping the back, especially if the person is in an upright position, since in this case, what is stuck in the throat may move lower.

What to do?

It is most difficult to cope with a problem when there is no one near the victim. To save his life, he will have to help himself get rid of the foreign body in the larynx. Food that gets into the windpipe will not go away on its own. She needs to cough it up. A cough can be provoked by bending forward and down, while inhaling slowly and sharply pushing the air out of the lungs. The process of expectoration is possible only if the larynx is not completely blocked.

If a person who has choked cannot cope on their own and the person suffocates, it is imperative to call an ambulance. In the meantime, it is necessary to provide first aid: tilt the victim forward and lightly tap between the shoulder blades several times (5 times is usually enough). Water or food debris should come out of your throat. If the method does not bring results, you need to use the Heimlich method:

Stand behind the patient.
Wrap your arms around him so that your hands meet in the area between the chest and the navel.
Make a fist with your other hand around it.
Press your fist at the indicated point, while squeezing your elbows and raising your fist up to your chest. Carry out the manipulation until the patient can breathe on his own.

Doctors advise combining tapping on the back in the interscapular area and the Heimlich method, performing them in turn. Please note that in the case of pregnant women, this method is also acceptable, but you need to press not on the stomach, but at the base of the chest (to avoid damage to the fetus). It’s worth acting in the same way when saving an overweight person.

A food product stuck in the esophagus can not only cause a feeling of discomfort. It may well damage the walls of this section of the gastrointestinal tract. Such consequences cannot be treated on your own; it is recommended to consult a doctor.

Loss of consciousness during asphyxia due to the failure of air to pass into the lungs due to the larynx being blocked by food particles is not uncommon. It is recommended to place the patient on his back (the victim's head should not turn). Feel free to sit on top, then place your fist between the navel and the inframammary area and apply pressure several times, performing the same movements as if you were standing behind the person and using the Heimlich method.

How to help a child?

If something gets into the throat of a small child, under no circumstances should you try to remove the object with your fingers: crumbs from the larynx can get into the respiratory tract. In addition, the pharynx and mucous tissues in children are too delicate, they can be easily damaged - this will lead to serious complications and long-term rehabilitation. The first thing to do is call an ambulance team.

When you are waiting for doctors, you cannot sit idly by. Make sure your child's nose is clear of mucus. If the baby chokes, turn him over on his tummy, lift him by the legs so that his head is lower than his body, and lightly tap him on the back. But use this method only if you have the skill of saving a person in a similar situation. If you are not confident in your abilities, it is better not to take risks: a careless blow with a little more force than required can not only block breathing even more, but also lead to rupture of the lungs.

Children over 10 years old can free their breathing using the Heimlich method.

On the Internet on forums you can also find information that if a child chokes on water or milk, raise his hands up.

To avoid food or drink getting into the trachea or lungs, you must always remember the saying “When I eat, I am deaf and dumb!” As practice shows, food or water goes down the wrong throat of an adult at the moment when he wants to express his opinion.

Contents of the article

Definition

A severe pathology that is life-threatening for patients when foreign bodies enter, during their stay in the respiratory tract and during their removal due to the possibility of lightning-fast development of asphyxia and other severe complications.

Classification of foreign bodies in the respiratory tract

Depending on the level of localization, foreign bodies of the larynx, trachea and bronchi are isolated.

Etiology of foreign bodies in the respiratory tract

Foreign bodies usually enter the respiratory tract naturally through the oral cavity. It is possible for foreign bodies to enter from the gastrointestinal tract during regurgitation of gastric contents, the crawling of worms, as well as the penetration of leeches when drinking water from reservoirs. When coughing, foreign bodies from the bronchi that had previously entered there can penetrate into the larynx, which is accompanied by a severe attack of asphyxia.

Pathogenesis of foreign bodies in the respiratory tract

The immediate cause of foreign body entry is an unexpected deep breath, which carries the foreign body into the respiratory tract. The development of bronchopulmonary complications depends on the nature of the foreign body, the duration of its stay and the level of localization in the respiratory tract, on concomitant diseases of the tracheobronchial tree, the timeliness of removal of the foreign body using the most gentle method, and on the level of qualification of the emergency physician.

Clinic of foreign bodies in the respiratory tract

There are three periods of clinical course: acute respiratory disorders, latent period and period of development of complications. Acute respiratory disorders correspond to the moment of aspiration and passage of a foreign body through the larynx and trachea. The clinical picture is bright and characteristic. Suddenly, in the midst of complete health during the day, while eating or playing with small objects, an attack of suffocation occurs, which is accompanied by a sharp convulsive cough, cyanosis of the skin, dysphonia, and the appearance of petechial rashes on the skin of the face. Breathing becomes stenotic, with retraction of the chest wall and frequently recurring bouts of coughing. Entry of a large foreign body can cause instant death due to asphyxia. There is a threat of suffocation in all cases of a foreign body entering the glottis. During subsequent forced inspiration, smaller foreign bodies are carried into the underlying sections of the respiratory tract. The latent period begins after the foreign body moves into the bronchus, and the further the foreign body is located from the main bronchi, the less pronounced the clinical symptoms are. Then comes the period of development of complications.

Foreign bodies of the larynx cause the most serious condition of patients. The main symptoms are severe stenotic breathing, sharp paroxysmal whooping cough, dysphonia to the extent of aphonia. With pointed foreign bodies, there may be pain behind the sternum, which intensifies with coughing and sudden movements, and an admixture of blood appears in the sputum. Choking develops immediately when large foreign bodies enter or increases gradually if pointed foreign bodies get stuck in the larynx due to the progression of reactive edema.

Foreign bodies in the trachea cause a reflex convulsive cough, which intensifies at night and with restless behavior of the child. The voice is restored. Stenosis from constant when localized in the larynx becomes paroxysmal due to the protrusion of a foreign body. Balloting of a foreign body is clinically manifested by the “pop” symptom, which is heard at a distance and occurs as a result of impacts of a moving foreign body on the walls of the trachea and on the closed vocal folds, preventing the removal of the foreign body during forced breathing and coughing. Ballistic foreign bodies pose a great danger due to the possibility of strangulation in the glottis and the development of severe suffocation. Respiratory disturbance is not as pronounced as with foreign bodies in the larynx, and is repeated periodically against the background of laryngospasm caused by contact of a foreign body with the vocal folds. Self-removal of a foreign body is prevented by the so-called valve mechanism of the tracheobronchial tree (the “piggy bank” phenomenon), which consists in expanding the lumen of the airways when inhaling and narrowing it when exhaling. Negative pressure in the lungs carries the foreign body into the lower respiratory tract. The elastic properties of the lung tissue, the strength of the diaphragm muscles, and the auxiliary respiratory muscles in children are not so developed as to remove a foreign body. Contact of a foreign body with the vocal folds during coughing causes a spasm of the glottis, and the subsequent forced inhalation again carries the foreign body into the lower respiratory tract. In case of foreign bodies in the trachea, a boxy tint of the percussion sound is determined, weakening of breathing throughout the entire pulmonary field, and during radiography, increased transparency of the lungs is noted.

When a foreign body moves into the bronchus, all subjective symptoms cease. The voice is restored, breathing stabilizes, becomes free, compensated by the second lung, the bronchus of which is free, coughing attacks become rare. A foreign body fixed in the bronchus initially causes meager symptoms, followed by profound changes in the bronchopulmonary system. Large foreign bodies are retained in the main bronchi, small ones penetrate into the lobar and segmental bronchi.

Clinical symptoms associated with the presence of a bronchial foreign body depend on the level of localization of this foreign body and the degree of obstruction of the bronchial lumen. There are three types of bronchostenosis: with complete atelectasis, with partial, along with a displacement of the mediastinal organs towards the obstructed bronchus, unequal intensity of the shadow of both lungs, bevel of the ribs, lag or immobility of the dome of the diaphragm when breathing on the side of the obstructed bronchus are noted; with ventilation, emphysema of the corresponding part of the lungs is formed.

Auscultation determines weakening of breathing and vocal tremor, according to the location of the foreign body, and wheezing.
The development of bonchopulmonary complications is facilitated by impaired ventilation with the exclusion of significant areas of the pulmonary parenchyma from breathing; Damage to the walls of the bronchi and infection are possible. In the early stages after aspiration of a foreign body, asphyxia, laryngeal edema, and atelectasis predominantly occur in the area of the obstructed bronchus. Atelectasis in young children causes a sharp deterioration in breathing.
Trachebronchitis, acute and chronic pneumonia, and lung abscess may develop.

Diagnosis of foreign bodies in the respiratory tract

Physical examination

Percussion, auscultation, determination of vocal tremor, assessment of the general condition of the child, the color of his skin and visible mucous membranes.

Laboratory research

Common clinical tests that help assess the severity of inflammatory bronchopulmonary processes. Instrumental studies
Chest X-ray with contrast foreign bodies and chest X-ray with aspiration of non-contrast foreign bodies in order to detect the Holtzknecht-Jacobson symptom - displacement of the mediastinal organs towards the obstructed bronchus at the height of inspiration. Bronchography, which specifies the localization of a foreign body in the tracheobronchial tree if it is suspected of moving beyond the bronchial wall. X-ray examination allows you to clarify the nature and causes of complications that arise.

Differential diagnosis of foreign bodies in the respiratory tract

Carry out with respiratory viral diseases, influenza stenosing laryngotracheobronchitis, pneumonia, asthmatic bronchitis, bronchial asthma, diphtheria, subglottic laryngitis, whooping cough, allergic edema of the larynx, spasmophilia, tuberculosis of the peribronchial nodes, tumor and other diseases that cause various types of breathing disorders and bronchostenosis .

Treatment of foreign bodies in the respiratory tract

Indications for hospitalization

All patients in whom aspiration of a foreign body is confirmed or suspected are subject to immediate hospitalization in a specialized department.

Non-drug treatment

Physiotherapy of developed inflammatory diseases of the bronchopulmonary system, inhalation therapy; oxygen therapy for severe stenosis.

Drug treatment

Antibacterial, hyposensitizing, symptomatic treatment (expectorants, antitussives, antipyretics); inhalation therapy.

Surgical treatment

Final visualization and removal of foreign bodies is performed during endoscopic interventions. Foreign bodies are removed from the laryngeal part of the pharynx, larynx and upper parts of the trachea under mask anesthesia using direct laryngoscopy. Foreign bodies from the bronchi are removed by tracheobronchoscopy using a Friedel system bronchoscope under anesthesia. Magnets are used to remove metallic foreign bodies.
In adult patients, fibrobronchoscopy is widely used to remove aspirated foreign bodies. In childhood, rigid endoscopy remains of primary importance.

The laryngeal mask greatly facilitates the passage of the fiberscope into the lower respiratory tract.
Indications for tracheotomy for aspirated foreign bodies:
asphyxia due to large foreign bodies fixed in the larynx or trachea;
pronounced subglottic laryngitis, observed when foreign bodies are localized in the subglottic cavity or developed after surgical intervention when removing a foreign body;
inability to remove a large foreign body through the glottis during upper bronchoscopy;
ankylosis or damage to the cervical vertebrae, which does not allow removal of the foreign body by direct laryngoscopy or upper bronchoscopy.
tracheotomy is indicated in all cases when the patient is in danger of death from suffocation and there is no possibility of sending him to a specialized medical institution.
In some cases, thoracic intervention is performed for aspirated foreign bodies. Indications for thoracotomy:
movement of a foreign body into the lung tissue;
a foreign body wedged into the bronchus after unsuccessful attempts to remove it during rigid endoscopy and fibrobronchoscopy;
bleeding from the respiratory tract when attempting endoscopic removal of a foreign body;
tension pneumothorax during aspiration of pointed foreign bodies and the failure of their endoscopic removal;
deep destructive irreversible changes in a segment of the lungs in the area where the foreign body is localized (removal of the affected area of the lungs along with the foreign body in such cases prevents the development of extensive suppurative changes in the lung tissue).
Possible complications when removing aspirated foreign bodies include asphyxia, arrest of cardiac activity and breathing (vagal reflex), bronchospasm, laryngeal edema, reflex atelectasis of the lung or its segment, occlusion of the airways with exhaustion of the cough reflex and paresis of the diaphragm.
When removing pointed foreign bodies, perforation of the bronchial wall, subcutaneous emphysema, mediastinal emphysema, pneumothorax, bleeding, injury to the mucous membrane of the larynx, trachea and bronchi are possible.

Prognosis of foreign bodies in the respiratory tract

Always serious, depends on the nature, size of the aspirated foreign body, its location, timeliness and completeness of the examination of the patient and the provision of qualified medical care, and on the age of the patient. The cause of a serious condition and even death of patients during aspiration of foreign bodies can be asphyxia when large foreign bodies enter the larynx, severe inflammatory changes in the lungs, bleeding from the great vessels of the mediastinum, tension bilateral pneumothorax, extensive mediastinal emphysema, lung abscess, sepsis and other conditions.

A foreign body is any foreign object that enters the human body. A huge danger is posed by foreign objects getting stuck in the lumen of the respiratory tract. Such foreign bodies interfere with normal breathing. The victim's condition directly depends on the quality of the object and the level of its jamming. In some situations, timely provision of first aid can save a person’s life.

Reasons for foreign body entry

Most often, pieces of food act as foreign bodies in the respiratory tract. Eating a quick snack and talking while eating are risk factors for the development of this condition.

The anatomical and physiological characteristics of the human body provide for the separation of two acts: swallowing and breathing. When a bolus or liquid is swallowed, the lumen of the larynx is closed by a cartilaginous structure (epiglottis). The rest of the time there is a passable connection between the nasopharynx and the underlying respiratory tract.

Discoordination in the functioning of the epiglottis when eating food or involuntary swallowing of food during inhalation leads to the entry of a bolus of food into the larynx or trachea.

Children (mostly under the age of 5) due to their curiosity, taste any foreign objects. In adults, needles and nails can also be found in the lumen of the respiratory tract. The habit of seamstresses and men to hold the necessary tool with their teeth can result in it getting stuck in the laryngopharynx.

The entry of a foreign body into a certain level of the airways leads to the following changes:

Item localization	Features and consequences
Nose	Nasal breathing is impaired. Mostly found in pediatric practice. Small children put small objects into their nostrils and then push them further as they try to get them out. Since it is possible to breathe through the mouth, the general condition does not suffer
Pharynx	Fish bones often get stuck at this level. Inflammation develops due to the introduction of a foreign body into the mucous membrane
Larynx and upper trachea	When the object is large, the lumen of the breathing tube is completely blocked. The victim cannot breathe. The risk of death is extremely high. Small foreign bodies that are not fixed in one position will move, preventing a rapid and sharp deterioration of the condition
The lower part of the trachea at the level of bifurcation (division into bronchi)	Small objects do not block the air supply to both lungs. A change in position provokes alternate closure of the lumen of the left or right bronchus
Bronchus	There is a blockage of the airways below the level of the foreign body. Over time, the corresponding part of the lung collapses

Manifestations

Signs of a foreign body entering the respiratory tract appear immediately and against the background of complete health. It is almost always possible to identify a connection between the deterioration of the condition and choking on food or swallowing a foreign object. The victim exhibits the following symptoms:

Dry, debilitating cough. A protective reflex is triggered to remove an object from the respiratory tract.
Inspiratory dyspnea. The person cannot take an effective breath. The overall picture is complemented by wheezing and wheezing.
Hoarse voice. Speech changes due to an obstruction to the flow of air. This is especially noticeable with foreign bodies in the larynx, since the vocal cords do not close.
A bluish tint to the skin. Slight puffiness appears in the face and neck area.
Loss of consciousness. This happens in severe cases, breathing also stops, and the pulse gradually disappears.

Entry of a foreign body into the lower respiratory tract is not accompanied by severe symptoms. A person’s well-being may not suffer for days or even weeks. The presence of a foreign object in the distal sections of the bronchi is often manifested by associated inflammation or the gradual development of respiratory failure.

Getting small objects stuck in the nose is often one-sided. Parents notice that the child is picking at one nostril, from where blood often appears or mucopurulent contents are released.

Urgent measures

A cough that occurs when a foreign object enters the respiratory tract is aimed at removing the object. This protective mechanism is capable of saving the victim itself. In the first moments after choking, there is no need to slap the choking person on the back. Otherwise, there is a high probability of a foreign object moving into the underlying departments and aggravating the situation.

If the victim cannot cough up the object, then call an ambulance and begin emergency procedures. The technique for removing a foreign body from the airways consists of two techniques:

Place yourself in a position with your head down and strike with the base of your hand between the shoulder blades. Strike five times in the direction from the interscapular space to the head.
Heimlich maneuver (or Heimlich). The person providing assistance stands behind the victim and wraps his arms under his chest. The hands make a lock in the epigastric region: one hand is taken into a fist, the other holds it from above. Perform five strong push-like pressures towards yourself and upward. Thanks to this action, the pressure in the chest cavity sharply increases, creating a force to eject the stuck object.

Cases when “something not living” gets into the respiratory tract are not that uncommon. This especially often happens to babies who play with small objects or accidentally inhale food while eating. The presence of a foreign object in the respiratory tract is a direct threat to the child’s life, so the first thing you should do is seek medical help.

It’s so simple to say, but what can the parents themselves do while the ambulance arrives and how to recognize in time the real reason for the child’s inappropriate behavior? So, in order for you to know more about this, the editors of the site and I decided to talk today about a foreign body in the respiratory tract in children, first aid, and consider the symptoms of this.

Otolaryngologists quite often have to remove a variety of nuts, coins, grains, badges, needles, balls, bones, paper clips, buttons, toy parts and buttons from a child’s nose, larynx, bronchi, trachea and lungs. Therefore, parents should be especially careful, since often their children cannot explain what happened to them, and help may be late.

The baby learns about the world and, studying the surrounding objects, he often tastes them. Most often, aspiration (inhalation) of foreign objects occurs between the ages of one and a half to three years. Since the baby is just learning to cope with solid food, his swallowing functions are not yet perfect, and he can easily choke while eating.

A foreign body, once in the respiratory tract, blocks the lumen of the trachea or bronchi. This overlap can be either complete or partial. With partial breathing, the baby can still breathe, albeit with difficulty. Complete overlap is characterized by the action of a foreign object, like a valve. In this case, the air entering the respiratory tract cannot be exhaled, since their lumen is blocked.

If a child's airway is completely blocked, then parents have only a few minutes to save his life.

A foreign body can become firmly fixed in one place, and it can also move along the respiratory tract. The trachea and larynx are considered the most dangerous, because if emergency assistance is not provided, death occurs within a few minutes.

Symptoms of a foreign body entering the respiratory tract:

The child suddenly begins to cough. His breathing becomes loud and wheezing, and his skin becomes cyanotic. Severe shortness of breath may occur. If a child cries, his voice becomes muffled and muffled.

When coughing, sputum with some admixtures of blood may be released, and squelching sounds can be heard when the baby breathes.

If an object gets into one of the branches of the bronchi, if the child was not supervised, parents may often not even be aware of the true cause of these symptoms. They may blame everything on a cold and not even see a doctor, self-medicating. This can be very dangerous for the baby's life, regardless of the size of the objects.

If the bronchi are constantly blocked, this can lead to the development of pneumonia, emphysema, purulent pneumonia, pneumothorax, bronchial asthma, and pleurisy. If a child inhales some organic object, for example, a seed, it begins to decompose, leading to severe infected inflammation. This also threatens the baby's life.

If you have even the slightest suspicion of aspiration, give your baby first aid (if the airway is completely blocked) and quickly take him to the doctor.

First aid:

If a foreign body gets into the baby's nose, you should not take it out from the outside, especially if it is round in shape. Ask your baby to blow his nose while pinching his free nostril. If this does not help, seek medical attention immediately at the nearest hospital. All this time, keep an eye on the child; he should stand or sit, not cry, and under no circumstances push the foreign body deeper.

If your baby inhales something and you observe choking, immediately provide first aid. Tilt his torso forward and sharply hit the flat of your palm on the back in the area between the shoulder blades. Repeat several times.

Grasp the child from the back, clasp your hands and place them in the middle of the abdomen, directly under the ribs. Use the protruding crook of your thumb to apply firm upward pressure to the epigastric region. Repeat very sharply several times.

If the baby has lost consciousness, place him on your bent knee, positioning him with his stomach down so that his head is lower. Strike sharply with your palm on the back in the area between the shoulder blades. Repeat as needed.

Call emergency medical assistance as quickly as possible. Your loved ones can do this while you are helping your baby.

Treatment of children who have inhaled something is carried out in otolaryngology departments using tracheobronchoscopy or endoscopic forceps. The child is under general anesthesia at this time.

After the foreign body has been removed, it is recommended to carry out certain treatment that will avoid possible inflammatory processes in the lungs and bronchi. The doctor prescribes a course of antibiotics, physiotherapeutic procedures, massage, therapeutic exercises, etc.

If the object was in the respiratory tract for a sufficiently long period of time, this can lead to complications of varying severity - necrosis, pneumosclerosis, tissue pressure sores and bronchiectasis.

If the lung tissue is irreversibly changed, surgery is performed to remove the affected area.

After something has been extracted, the baby should be observed by an otolaryngologist for some time. After two months, a full examination of the respiratory tract is recommended, aimed at identifying hidden pathological processes.