Foreign body in the breath. Principles of Immediate Assistance

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 got into 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 are careless and sometimes irresponsible about the advice of experts: drink and eat slowly, do not talk at this time, and chew food thoroughly. Such neglect of simple rules can cost health, and in some cases lead to a tragic outcome: food gets into the wrong place and moves down another path intended for air.

• Older people who, due to their anatomical capabilities (lack of teeth or improperly 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, a cleft lip).

A person who chokes on saliva or a sip of water will certainly begin to cough. This is a great way to free the airways from the fluid that has got there. Most often, these people do not need outside help. But if a solid foreign body (a seed, seeds from an apple or a berry, bread crumbs) gets into the wrong throat, breathing is blocked partially or completely, the person begins to suffocate. The face changes color to pale or, conversely, burgundy.

It is important that the choking person does not panic, because 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, do not "help" the patient by random tapping on the back, especially if the person is in an upright position, because in this case, what is stuck in the throat can move lower.

What to do?

The hardest thing to deal with the problem is when there is no one near the victim. To save his life, he will have to help himself get rid of a foreign body in the larynx. Food that gets into the windpipe does not go anywhere on its own. She needs to be coughed up. Coughing can be provoked by leaning forward and down, while slowly inhaling and expelling the air sharply from the lungs. The process of expectoration is possible only when the larynx is not completely blocked.

If the choking person does not cope on his own, the person suffocates, it is imperative to call an ambulance. In the meantime, it is necessary to provide first medical aid: tilt the victim forward and lightly tap between the shoulder blades several times (5 times, as a rule, is enough). Water or leftover food should come out of the throat. If the method did not bring results, you need to use the Heimlich method:

1. Stand behind the patient.
2. Embrace him with your arms so that your hands converge in the area between the chest and the navel.
3. Clench your fist with your other hand.
4. Press your fist at the indicated point, while clenching your elbows and raising your fist up to your chest. Carry out the manipulation until the patient can breathe on his own.

Doctors advise to combine tapping on the back in the interscapular region 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 is also worth acting to save an overweight person.

A food product that has stopped in the esophagus can not only deliver a feeling of discomfort. It may well damage the walls of this section of the gastrointestinal tract. Such consequences cannot be treated on their own, it is recommended to consult a doctor without fail.

Loss of consciousness during asphyxia due to the obstruction of air into the lungs due to the blocked larynx with food particles is not uncommon. It is recommended to put the patient on his back (the head of the victim should not turn). Boldly sit down from above, then placing a fist between the navel and infrabreast area, press several times, performing the same movements as if you were standing behind a person and applying the Heimlich method.

How to help a child?

If something gets into the throat of a small child, in no case should you try to get the object with your fingers: a crumb 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 to call an ambulance team.

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

Children over 10 years of age can release their breath 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 getting food or drink 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 gets into the wrong throat for an adult at the moment when he wants to express his opinion.

Situations in which a foreign body can enter the respiratory tract are not uncommon. Active communication and laughter during meals, hasty absorption of food with poor chewing, alcohol intoxication are the most common causes of such cases in adults.

But even more often cases of foreign objects entering the respiratory tract occur with children (more than 90%). They like to take small objects in their mouths, spin around, talk, laugh and play while eating.

Sometimes it is enough for the victim to cough quickly enough to clear the airways. But if the coughing fits continue, the person begins to grab his throat, cannot breathe, his face, which at first turned red, begins to turn pale, and then turn blue - emergency care is required. Delay threatens his life and health. It is necessary to immediately call an ambulance and take urgent measures to free the airways before the arrival of doctors.

Removal of a foreign body from the respiratory tract using the Heimlich maneuver

In children

Signs: The victim is suffocating, unable to speak, suddenly becomes bluish, may lose consciousness. Often children inhale parts of toys, nuts, sweets.

In adults

In pregnant women or obese victims (it is impossible or impossible to give thrusts to the abdomen).

If the victim has lost consciousness, call an ambulance and proceed with cardiopulmonary resuscitation. It is carried out only on a hard surface.

Continue resuscitation until medical personnel arrive or until spontaneous breathing is restored.

After restoring breathing, give the victim a stable lateral position. Ensure constant breath control until the arrival of an ambulance!

Everyone knows that it is better to prevent injuries or diseases than to be treated later and suffer from their consequences. To avoid getting into the respiratory tract of foreign bodies does not require much effort. It is enough to follow a few simple rules:

• do not rush to eat and chew food thoroughly;
• while eating, do not be distracted by conversations, disputes and showdown - violent emotions, laughter and sudden movements with a full mouth can end with Heimlich techniques;
• do not eat lying down, on the go on the street, in transport, especially while driving;
• to wean children and not to keep foreign objects in their mouths: pen caps, coins, buttons, batteries, and the like.

One of the most critical pathologies that anyone can encounter is a foreign body in the airways. Emergency assistance in these situations should be provided instantly - in the first seconds. Certain maneuvers that everyone can master can save the life of an adult and a child if they are applied immediately.

At times more often this pathology develops in patients of childhood. This is due to the peculiarities of the behavior of babies - while eating, they tend to play, talk, laugh or cry, cough. In addition, children very often take various small objects into their mouths, which they can then accidentally inhale. The anatomical features of the oral cavity and the underdevelopment of protective reflexes in children also contribute to an increase in cases of aspiration (inhalation) of foreign bodies (FB) in young patients.

Adults most often suffer from this pathology when greedily absorbing food without chewing it, or when actively talking while eating. Another "aggravating circumstance" is alcohol intoxication, which reduces the activity of the nerve centers responsible for protective reflexes.

Symptoms of a foreign body in the airways

A feature of this pathology is that most often it occurs during meals. This is important information that suggests that a person loses consciousness precisely due to a foreign body, and not, for example, a heart attack (although this is also possible).

The clinical picture of a foreign body goes through three stages in its development:

• initial stage, in which there is a sudden strong paroxysmal cough, lacrimation, redness of the face;
• development- the cough becomes stronger, there is practically no breathing, although the patient makes respiratory movements, cyanosis appears around the lips;
• final stage, during which breathing stops, the person loses consciousness, after a short time, cardiac arrest is observed, followed by clinical death.

How to recognize a foreign body in the airways by external signs

The moment when a foreign body enters the respiratory tract looks like this:

• suddenly the person stops talking, laughing, screaming or crying, grabs his throat with his hands;
• there is a strong cough, the victim stops answering questions;
• when the victim tries to inhale, either wheezing is heard, or nothing is heard; the victim opens his mouth wide, but cannot inhale;
• the face, initially reddening, quickly becomes pale, and then acquires a bluish color, especially in the region of the upper lip);
• within a few tens of seconds, there is a loss of consciousness due to respiratory arrest;
• in a very short time, the work of the heart stops and clinical death occurs.

First aid for foreign bodies in the respiratory tract

A person who knows how to recognize this pathology will not waste a second. The situation is developing rapidly and delaying first aid can cost the victim his life.

The algorithm of actions for this pathology is as follows:

1. Address the victim with the question “What happened?” You may look stupid, but in reality this question is needed in order to understand whether a person is breathing at least somehow. Your further tactics will depend on this.
2. If a person is somehow breathing, encourage him with the words “Cough, harder, more, come on” - with any words that “break through” to his consciousness. Often this is enough for a small foreign body that has entered the upper respiratory tract to come out on its own.
3. If spontaneous release of IT did not occur within 30 seconds, or if the person did not breathe from the very beginning, then the Heimlich maneuver should be applied.

Heimlich maneuver

The technique for doing it is as follows:

• Stand behind the victim.
• Grasp his torso with both hands, cover the fist of your right hand with the palm of your left hand, and use the knuckle of your right thumb to press five hard pressures on the upper abdomen. The direction is up and towards you. Restoration of breathing is a sign of removal of a foreign body from their airways.

Note: The Heimlich maneuver should be performed until the FB leaves the airway or until the person is unconscious. In the latter case, attempts to remove the foreign body should be stopped, and instead start.

Features of the Heimlich maneuver in children and pregnant women

When removing a foreign body in the respiratory tract in children under 1 year old, the rescuer should sit down, put the child on the left forearm face down, holding the lower jaw of the baby with fingers folded into a “claw”. The head of the child should be below the level of the body. After that, five medium-strength blows should be applied with the base of the palm to the interscapular region of the back. The second stage - the child turns face up on the right forearm, after the forehead, the rescuer makes five jerky movements along the sternum to a point located 1 finger below the inter-nipple line. Don't push too hard to break the ribs.

If a foreign body has appeared in the oropharynx, it is visible and can be removed without the danger of pushing it back - it is removed. If not, the whole cycle is repeated either until IT appears, or until cardiac arrest, after which cardiopulmonary resuscitation should be started.

In children aged 1-8 years, the Heimlich maneuver is performed by placing the child on the rescuer's thigh. The rest of the actions are performed according to the general rules.

You will receive more detailed information about emergency care for a child when a foreign body enters the respiratory tract by watching a video review by a pediatrician, Dr. Komarovsky:

An important question: “What if a pregnant woman was injured?” Indeed, pressing on the stomach of a woman who is at a long pregnancy is guaranteed to lead to serious complications. In this case, pressing is done not on the stomach, but on the lower part of the sternum, as in infants.

Common Mistakes in Airway Foreign Body Removal

The first thing that comes to mind when a foreign body enters the respiratory tract is to knock on the back. The correct algorithm for how to knock is described above. However, most of us just pound on the back with all our might. The danger of this method is that gravity acts on any foreign body. Incorrect tapping may cause IT to penetrate lower into the tracheobronchial tree and may cause complete airway obstruction. First aid in this case is to carry out a tracheotomy, and even if by some miracle a qualified specialist turns out to be nearby, the chance of saving the victim will become scanty.

Never turn your baby upside down to shake him. Spasm of the larynx reduces your attempts to remove a foreign body to zero. Instead, you can dislocate the baby's cervical vertebrae. The fact is that when a child loses consciousness, the tone of the muscles of the neck drops, while shaking, his head begins to dangle in all directions, which can lead to dislocation of the cervical vertebrae and even their fracture. Saving a baby from death, you risk making him disabled or even killed.

Such an extremely unpleasant situation as a foreign object entering the respiratory tract (nasopharynx, larynx) occurs quite often. It is more likely to occur in children under 5 years of age. It is at this age that he actively learns the world around him, using not only his hands, but also his mouth. There is also the possibility that a small object can simply be inhaled by the child.

At an older age, the ingress of a foreign body into the respiratory tract occurs during games, jokes, eating too fast, and/or unsuccessful experiments. How to behave in such a situation, how to help the victim, and what first signs you should pay attention to, we will consider in this article.

Main symptoms

Depending on the size of a foreign object in the airways, it is able to completely or partially close them, blocking the access of oxygen to the lungs. In addition, a foreign body can injure the larynx, vocal cords, causing inflammation and swelling, thereby worsening the situation. With a partial variant, breathing will be heavy, difficult and intermittent. Sometimes a person can take a breath, but instead of exhaling there will be a creak or whistle. The most dangerous situation is when a foreign object completely blocks the breathing process, blocking the lumen of both bronchi at once. In this case, the risk of death is high.

How to understand that the cause of suffocation is precisely a foreign body, and not a strong allergic reaction, for example?

Signs of a foreign body in the airways

1. Abrupt and sudden change in behavior. Movement becomes chaotic. A person, as a rule, grabs his throat and loses the ability to speak.
2. Redness of the skin of the face, enlargement of the veins in the neck
3. Cough as an attempt by the body to get rid of an object
4. Breathing is difficult. When you inhale, you can hear strong wheezing
5. Due to a sharp lack of oxygen, the skin above the upper lip may acquire a bluish tint.
6. Rapid loss of consciousness

Such symptoms are characteristic of the active phase with complete blockage of the airways, if the object has stopped in the larynx or trachea. The disease develops rapidly, and assistance should be provided as quickly and efficiently as possible.

If a small object, with a sharp breath or cough, passed through the larynx and got stuck in the bronchi, then the first sharp external symptoms may be absent, or appear from time to time. In this case, a sluggish inflammatory process occurs, which may be accompanied by: fever, short-term bouts of asphyxia, coughing, shortness of breath, vomiting. It is possible to determine the cause only with the help of x-rays.

It should be remembered that with improper assistance, you can move the foreign object inward, and thus only worsen the condition of the victim.

Foreign body in the airways and first aid

Depending on the age of the victim, you need to act differently in order to avoid worsening the condition. An adult must be tilted forward so that the head is lower than the body. It is advisable to fix this position, holding your hand at the waist. Hit the base of the palm sharply on the back in the place between the shoulder blades. Hits must be clear. If 5 attempts were unsuccessful, and it was not possible to get rid of the foreign object, then they resort to the Heimlich method.

1. It is most convenient to use it in a standing position. You need to take a stable position so that if the victim loses consciousness, you can hold him.
2. From the back, grab the victim with both hands in the abdomen, just above the stomach.
3. Squeeze your working hand into a fist, and the second - fix it. Pay attention that your thumb is tightly pressed to the fist, otherwise you may injure the person.
4. Do quick pushes inward, and then up, pressing your fist into your stomach.
5. It is necessary to do 5 pushes without a break.

In the case when the victim is unconscious, it is already too late to resort to such a technique. Start measures for (artificial respiration) before the arrival of specialists, or before the first independent breaths of the victim.

An adult who is overweight or in pregnant women should not be thrust into the abdomen. Here you should fasten your hands on the lower border of the chest (above the abdomen) and act according to the described scheme.

Foreign bodies in the upper respiratory tract in infants or toddlers under 1 year of age can be removed using a slightly different tactic. The child should be placed on the stomach on the forearm and tilted down, holding the neck, and keeping the mouth open. Controlling the strength, make 5 hand claps between the shoulder blades of the back. If the object does not come out, then turn the child to face you. Press on the chest with 2 fingers until the foreign body can be removed. Be careful with the force applied, the child's ribs can easily crack.

When the person began to breathe on his own, turn him to the side and wait for the ambulance to arrive. Call it will be necessary in any case.

Common first aid mistakes

When a foreign body is inhaled into the respiratory tract, assistance must be provided correctly, on time and quickly. Such situations pose a threat to human life, so a mistake made can lead to a tragic result.

Very often, people, trying to help, allow the following wrong actions:

1. When coughing, do not beat the victim between the shoulder blades. It's best not to intervene at all until you see signs of suffocation. Coughing means that the airways are not completely blocked, and the body can cope with this problem on its own.
2. You don’t need to pound your fist on the back with all your might, otherwise you can damage the internal organs or ribs, and achieve only the opposite result. It is correct to do this with the base of the palm clearly and with medium strength. After each impact, check that the foreign object is still in the airway.
3. A baby up to six months cannot be grabbed by the legs, turning his head to the floor, and shaking that - there is strength. At this age, the cervical vertebrae are very unstable and mobile, you can damage or displace them with such movements.
4. Panic reduces time that the victim does not have. Act fast. To do this, you can take first aid courses or practice on yourself, do the Heimlich maneuver.

The Heimlich maneuver is a miraculous method developed by the American physician Henry Judah Heimlich in 1974. This is a method of assisting the victim, used to quickly free the person's respiratory tract from foreign objects or food debris. The reception is based on creating pressure in the abdominal cavity of the victim's abdomen, which allows you to push the foreign body out of the oropharynx. This method is discussed in more detail in the presented video.

The article is for informational purposes, you perform all actions at your own peril and risk, remember that no one has canceled the qualified assistance of specialists!

Very useful video, watching it, you can save someone's life!

- foreign objects accidentally aspirated or caught in the airways through the wound channels and fixed at the level of the bronchi. The foreign body of the bronchus makes itself felt with a paroxysmal whooping cough, asphyxia, cyanosis of the face, stenotic breathing, hemoptysis, vomiting, impaired phonation. A foreign body in the bronchi is recognized on the basis of the collected history, radiography of the lungs, tomography, bronchography, bronchoscopy. Removal of a foreign body from the bronchus is carried out endoscopically; with wedged foreign bodies resort to bronchotomy.

Causes of penetration of a foreign body into the bronchus

A foreign body can enter the bronchus by aspiration (when it is inhaled through the mouth, thrown from the esophagus and stomach with gastroesophageal reflux or vomiting), as well as through the wound channel in case of damage to the chest and lung. The penetration of foreign bodies is possible during surgical interventions: tracheotomy, adenotomy, removal of a foreign body from the nose, dental procedures. Among these mechanisms, the most common is the aspiration route of foreign bodies entering the bronchi.

Aspiration of foreign bodies into the bronchi contributes to the habit of children and adults to hold small objects in their mouths. The ingress of objects from the oral cavity into the bronchi occurs during the game, laughing, crying, talking, coughing, sudden fright, falling, etc. Often, the background for the aspiration of foreign bodies into the bronchi is concomitant rhinitis and adenoid growths, the state of anesthesia.

By their nature, foreign bodies of the bronchi are divided into endogenous and exogenous, organic and inorganic. Endogenous foreign bodies include non-extracted pieces of tissue during tonsillectomy and adenotomy, endoscopic removal of benign tumors of the bronchi, extracted teeth, roundworms.

The most diverse group of findings are exogenous foreign bodies of the bronchi: these can be small objects made of metal, synthetic materials, objects of plant origin. Among the exogenous foreign bodies of the bronchus, there are both organic (food particles, seeds and grains of plants, nuts, etc.) and inorganic (coins, paper clips, screws, beads, buttons, toy parts, etc.) objects. The greatest aggressiveness and difficulty in diagnosis are objects of organic origin, synthetic materials and tissues. They are not contrasted with x-rays, they can stay in the lumen of the bronchus for a long time, where they swell, crumble, and decompose; penetrate into the distal parts of the bronchial tree, causing chronic suppuration of the lungs.

Foreign bodies of the bronchi, having a smooth surface, are capable of moving, translational movement to the periphery. Objects of plant origin (spikelets of cereals and herbs), on the contrary, wedged into the wall of the bronchus and remain fixed. There are cases of single and multiple foreign bodies of the bronchus.

Pathological changes in foreign bodies of the bronchus

Pathological changes in the bronchi depend on the size, nature of the foreign body and the time it has been in the airways. In the initial period, generalized bronchospasm, local hyperemia, swelling and ulceration of the bronchial mucosa, and exudation occur. In later periods, a capsule is formed around the foreign body, granulations grow with their subsequent scarring.

Foreign bodies in the bronchi can occupy different positions, as a result of which various secondary changes in the lung tissue are observed. When balloting foreign bodies, the lumen of the bronchus is not completely blocked, external respiration is not critically disturbed, secondary inflammatory changes in the lung tissue are moderate.

With valve obstruction of the bronchus, there is a loose contact of the foreign body with the walls of the bronchus, therefore, on inspiration, air enters the lung, and on expiration, due to bronchospasm, it cannot exit back. Thus, air is retained in the lung tissue with the development of lung emphysema below the site of bronchial obstruction. With complete blockage of the bronchus by a foreign body in the underlying unventilated sections of the lung, obstructive atelectasis and atelectatic pneumonia occur.

A foreign body in the bronchus always brings an infection with it, which is accompanied by a local inflammatory reaction. Therefore, with long-term foreign bodies of the bronchi, non-resolving bronchitis, bronchopneumonia, deforming bronchitis, bronchiectasis, lung abscesses, broncho-pleuro-thoracic fistulas develop.

Symptoms of a foreign body in the bronchus

In the clinical symptoms of foreign bodies of the bronchi, three periods are distinguished: the debut phase, the phase of relative compensation of respiratory functions and the phase of secondary complications.

In the debut phase after aspiration of a foreign body, a sudden paroxysmal cough develops; aphonia, respiratory failure up to asphyxia. A similar picture is sometimes observed with diphtheria, however, in this case there is no suddenness factor, and pathological symptoms (sore throat, fever, etc.) precede the appearance of a cough. With false croup, catarrhal phenomena of the upper respiratory tract also precede an attack of coughing and suffocation. With benign tumors of the larynx, aphonia increases gradually. Cough attacks are often accompanied by vomiting and cyanosis of the face, reminiscent of whooping cough: this can cause diagnostic errors, especially in cases where the fact of aspiration is "viewed".

Shortly after the penetration of a foreign body into the main, lobar or segmental bronchus, a phase of relative compensation of the respiratory function begins. During this period, due to partial obstruction of the bronchus and bronchospasm, wheezing is heard at a distance - inspiratory stridor. There is moderate shortness of breath, pain in the corresponding half of the chest.

Further dynamics of the pathological process with foreign bodies of the bronchus depends on the severity of inflammatory changes that develop in the area of ​​the lung that is switched off from breathing. In the phase of complications, a productive cough with mucopurulent sputum, fever, hemoptysis, and dyspnea occur. The clinical picture is determined by the developed secondary complication. In some cases, foreign bodies of the bronchi go unnoticed and are an accidental finding during surgical interventions on the lungs.

Diagnosis of a foreign body in the bronchus

The difficulty of recognizing foreign bodies in the bronchi is due to the fact that the fact of aspiration cannot always be noticed. The non-specificity of symptoms often leads to the fact that persons with foreign bodies in the bronchi are treated for a long time by a pulmonologist for various broncho-pulmonary diseases. The reason to suspect the presence of a foreign body in the bronchi is ineffective therapy for asthmatic bronchitis, chronic bronchitis and pneumonia, whooping cough, bronchial asthma, etc.

Physical data with foreign bodies of the bronchus indicate the presence of atelectasis (a sharp weakening or absence of breathing, dullness of percussion sound) or emphysema (percussion tone with a box shade, weakened breathing). On examination, attention is drawn to the lagging of the affected side of the chest during breathing, participation in the act of breathing of auxiliary muscles, retraction of the jugular fossae and intercostal spaces, etc.

In all cases, if a foreign body of the bronchus is suspected, chest X-ray is indicated. In this case, narrowing of the bronchus, local emphysema, atelectasis, focal infiltration of the lung tissue, etc. can be detected. Clarification of the location of the foreign body and the nature of local changes in the lungs is performed using X-ray or computed tomography, NMR, bronchography.

The most reliable diagnostic method for visualizing foreign bodies in the bronchi is bronchoscopy. Often, due to the severity of local changes, a foreign body cannot be detected immediately. In such cases, granulations are removed, a thorough sanitation of the bronchial tree (bronchoalveolar lavage), a course of antibiotic therapy, and then an endoscopic examination of the bronchi is repeated.

Treatment of a foreign body in the bronchus

The presence of a foreign body in the bronchus is an indication for its extraction. In most cases, it is possible to perform endoscopic removal of a foreign body in the bronchus during repeated bronchoscopy. If a foreign body is detected in the lumen of the bronchus, the tube of the bronchoscope is carefully brought to it, the object is grasped with forceps and removed.

Metal objects can be removed with a magnet; small foreign bodies of the bronchi - using an electric suction. Then the bronchoscope is re-introduced to revise the bronchi for leaving "fragments", wounding the walls of the bronchus, etc. In some cases, the removal of foreign bodies from the bronchi is performed through a tracheostomy.

Foreign bodies that are tightly wedged into the wall of the bronchus are subject to surgical removal in the process of thoracotomy and bronchotomy. Indications for bronchotomy are fixed or impacted foreign bodies that cannot be removed without significant damage to the walls of the bronchi. They also switch to surgical tactics in case of complications when trying to endoscopically remove foreign bodies (rupture of the bronchus, bleeding).

Forecast and prevention of foreign bodies of the bronchi

With timely extraction of a foreign body in the bronchus, the prognosis is good. Complications of foreign bodies of the bronchus can be disabling and life-threatening diseases - pleural empyema, fistulas (thoracobronchial, esophageal-bronchial, broncho-pleural), pneumothorax, pulmonary hemorrhage, rupture of the bronchus, purulent mediastinitis, etc. In some cases, death of children from sudden asphyxia.

Preventive measures should include adult control over the quality of toys and their age-appropriateness; weaning children from the habit of taking foreign objects into their mouths; explanatory and educational work among the population; exercise caution in medical procedures.