Hello dear blog readers! The topic of our today's meeting is serious situations when the child suffers from , and gets a foreign body in the respiratory tract , into the throat, pharynx, esophagus or stomach. What to do in these cases? How to act properly if the child accidentally choked and give the first emergency help, and thereby save precious life? !Foreign bodies in children, especially in the respiratory tract, are of particular importance, since they lead to serious disturbances in the process of the act of breathing until it is completely stopped. In these cases, we only have 5 minutes to solve this problem.
Consider the recommendations of a pediatrician of the highest category Larissa Anikeeva, as well as the pediatrician EO Komarovsky. At the end of the publication, you can watch a visual training video on the topic.
Foreign bodies in the respiratory tract
What are the reasons the child is guided by thrusting foreign objects into his nose - is unknown. But the presence of pebbles, peas, seeds, straw in the nasal passages of children is a fairly common phenomenon. Having seen a foreign body in the nose of his beloved child, Mom hurries to remove it faster. But, not having at hand a suitable instrument, or the corresponding experience, often pushes it into the depth of the nasal cavity, from which only the otolaryngologist can extract it. Therefore, if you are not sure of the success of the operation, ask for help from a LOP doctor in the polyclinic, and in the evening in the admissions department of the hospital where there is an on-duty otolaryngologist.
Often the fact of introducing a foreign body into the nasal cavity remains an adult unknown.
A few days after the event, there are mucopurulent discharge with putrefactive odor, more abundant from one half of the nose, obstructed nasal breathing, snoring breath in a dream. The temperature may rise slightly. Usually mothers regard this condition as another "cold" and do not rush to see a doctor. Yes, and the pediatrician during the first inspection is not easy to guess about the presence of a foreign body. Only a persistent runny nose, which is not treated for a long time, and an unpleasant odor from the nasopharynx will allow one to suspect the introduction of a foreign object and send the baby to an otolaryngologist who will find the find and extract it.
Foreign bodies of the pharynx occur quite often and fall into it mainly with food.
The most common items extracted from the pharynx in children: fish and chicken bones, seeds and husks from them, different "inedible" trifles.
The clinical picture is so pronounced that there is usually no doubt: the sensation of an alien object and stitching pain in the throat, worse with swallowing, paroxysmal coughing and vomiting, with which the body seeks to remove the foreign body. Increased pain when swallowing forces the child to stop swallowing saliva, and the baby it flows out of the mouth, and the older child spits it out. These signs indicate the presence of a foreign body in the pharynx or in the tissue of the tonsils, and the parents have no choice but to turn to the otolaryngologist.
Removal of a foreign body from the pharynx is not difficult for a specialist, and after a few seconds your child is again cheerful and healthy.
The popular way to swallow a dry crust - sometimes it can help, but can drive a sharp bone deeper and make its extraction more difficult. Before contacting your doctor, you can try to remove the foreign body located on the surface, by rinsing your throat. But this procedure is able to perform a schoolboy, but for babies it is not good.
More serious matters are with the ingress of foreign bodies into the larynx and further into the trachea and bronchi.
Children often take in mouth various small objects and, keen on playing, talking and laughing while eating, draw them into the airways with an air current.
It is noticed that smaller and lighter objects enter the larynx, while the more massive and heavier ones rush into the esophagus, then into the stomach and in 1-2 days leave the body in a natural way.
Foreign bodies at the entrance to the larynx lead to reflex closure of the glottis, and are often removed independently under the influence of immediately developed convulsive paroxysmal cough, often accompanied by vomiting.
First emergency aid for a child when he choked on
If a foreign body, having slipped through this section, got into the voice gap and blocked it, there is a stop of breathing, asphyxiation and loss of consciousness.
The life of a child is hanging by a thread and depends on your actions.
Turn a small child upside down so that his face is facing your body. Holding his legs with one hand, the other one will tap on the back. Spend these activities over the sofa, armchair, bed, so as not to cause additional injury in the event of a fall.
Sit on a chair, put your baby's belly on his left knee, with his left hand, support his neck and chest, clamp his legs under his arm. With your right hand, apply a few strokes with an open palm( not with your fist!) Between your shoulder blades.
In the same position, press down on the root of the tongue or tickle the back of the pharynx, causing cough and vomiting reflexes.
Place the older child on a hard surface( on the floor) and apply a few sharp strokes between the shoulder blades.
Remember that at your disposal only 5 precious minutes, and rely only on yourself.
No "Ambulance", even on a magic carpet-plane, is not able to reach you during this time.
Resuscitation measures in the presence of a foreign body in the larynx will be ineffective, because the air blown by the rescuer can not overcome the existing obstacle.
As an act of desperation, is the last way to return a child to life - with a sharp knife to make an incision of soft tissues along the middle line of the neck, get to the trachea, open it and blow air into the hole, while performing indirect heart massage. During the operation, the patient should lie on his back with his head thrown back, under his shoulder blades it is necessary to put a roller from a folded blanket.
Not everyone is capable of such extreme actions, but in some cases this is the only way to save a person's life.
If the foreign body has slipped through the voice gap, the then the further development of events is not so threatening. It can linger in the trachea, attach to the wall, hide and for a long time can not detect anything by itself. Unless the child will cough from time to time. In the future, around the foreign object can form a capsule, a bag, which, as it increases, can cause difficulty in breathing, respiratory failure, prolonged inflammatory processes.
If you get into the bronchus, more often to the right, there is a reaction in the form of bronchospasm, which manifests itself by a painful cough with hard-to-separate sputum, complicated by "wheezing" breath, then an inflammatory process is joined in the form of an unresponsive bronchitis or pneumonia. It is good, if the mother or the child himself will remember about the possible foreign body entry into the respiratory tract. Then, using an endoscopic method of examination( bronchoscopy), you can detect and remove a foreign object. But not every mother will connect a long-term pneumonia with that old( three months ago) attack of a convulsive cough that suddenly happened to the child during assembly of the designer.
Thoracic surgeons( who perform operations on the thorax) can tell a lot of cases when the foreign body, which was for a long time in the esophagus, trachea, bronchi, caused the transition of the inflammatory process to the mediastinal organs, gave a clinical picture of the oncological disease, led to the development of chronic processes in the lungs,children with disabilities.
A teenage girl was resting at her grandmother in the village and during her time with her friends in the hayloft, she inhaled a thin straw. Did she attach importance to such "nonsense" as coughing? Of course, no, she forgot about him in a couple of minutes. Returning home, she began to cough, complain of shortness of breath at night, excessive sweating, quick fatigue. The doctor showed bronchitis, prescribed treatment with antibiotics, but no improvement was noted. They prescribed a stronger antibiotic, added physiotherapy treatment, but there was no effect. A painful cough with hard-to-separate sputum, which does not stop day nor night, exhausted the girl, turning a healthy rosy-cheeked person into a pale, feeble shadow. They suspected bronchial asthma, put them in a hospital, performed a checkup, found bronchospasm, a characteristic sign of bronchial asthma, and prescribed a modern treatment. It is not known what would have been the case, if one day during another attack of cough along with a purulent sputum from bronchuses an ill-fated straw did not jump out. And a few days later the girl became absolutely healthy.
Foreign bodies of the esophagus
Esophagus along its length has three narrowed sections, called physiological constrictions. These departments are most affected by pathological processes: ulceration, burns, scars, tumors. In them, usually, foreign bodies are trapped, which the child accidentally swallowed. Usually it is small details of toys, designers, coins, rings. If the candy is stuck in the esophagus( candy, toffee), after a minute it will melt, decrease in size and safely get to the stomach.
Non-food items expect a different fate - they will have to be removed during esophagoscopy - endoscopic operation .
How can a mother suspect a foreign body in the esophagus? The big child will say that he was holding a coin in his mouth( a toy, a detail from a designer, etc.) and accidentally swallowed it, and now feels the pain behind the sternum, which increases with the swallowing of saliva. For this reason, he stops swallowing, and saliva accumulates in the mouth and then spits out.
What do 99 moms of 100 do? First of all, of course, they begin to criticize the poor boy who is already frightened by what happened.
From mommy notations spasm in the esophagus only increases.
What to do and how to help the child
Take yourself in hand, calm yourself and calm the child. Prepare a warm drink, preferably with enveloping properties, capable of making the foreign body slippery and promote its movement into the stomach: kissel, broth of Hercules, rice broth, milk and butter. Let the child try to take a few sips. Sometimes these simple actions are sufficient to restore the passage of the esophagus.
If swallowing is disturbed, the liquid does not pass into the stomach, but pours out. Then you have to go to the hospital to extract a foreign body instrumentally.
A small child will not tell you anything. But attentive mom herself will notice that, among the overall health of the child, suddenly there was a paroxysmal cough, vomitive movements appeared, after which he became restless, somehow frightened, his head and neck fixed in one position, and every swallowing movement is accompanied by crying. Therefore, it stops swallowing saliva, and it flows out of the mouth. These symptoms are enough to suspect a foreign body of the esophagus and go to the hospital to remove it.
If the foreign body of the esophagus is not detected and is not removed in time, it can be osumkovatsya and for a while does not manifest itself.
But will later develop an inflammatory process in the esophagus - esophagitis, which can lead to perforation of the wall and the development of a formidable complication - inflammation of the mediastinal organs, which can lead to death.
Foreign body of stomach
Once again it should be emphasized that a child swallowed by a child and getting into a stomach is not an excuse for panic and does not require emergency measures.
Having traveled through the gastrointestinal tract, a foreign body will leave the body naturally, and you will find it in 36-48- 72 hours( sometimes in a week) in the contents of the pot.
Nature arranged the body so wisely, providing it with protective reactions, that even a sharp object( for example, an injection needle, an English pin) in the intestine is enveloped first by food, and then by calves and unfolds in such a way as not to injure the walls of the digestive tract. In very rare cases, there is a danger of penetration of a stitching object from the intestine into the abdominal cavity and adjacent organs. Then a surgical operation is required.
If the child chokes. What to do and how to help the child up to a year and a half?
What if I choke while eating, or playing with a small toy? The technique of rendering assistance is described. This file is not a tutorial. If you looked at this video course, it does not mean that you learned how to help children with ODUIT.Mandatory testing of manipulations with the dummy under the guidance of the instructor.
If foreign bodies get into the respiratory tract in children
Foreign body in the respiratory tract: emergency care - Dr. Komarovsky
What if the child shoved something in the nose or something choked the adult? Should I knock on my back and how to do it correctly? In what cases immediately call an ambulance and perform resuscitation? These and other questions will be answered by Dr. Komarovsky and reminds his parents that the principle of "when I eat, I am deaf and dumb" is relevant for everyone, and small items and a small child can be crossed only in the presence of adults.
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- «Pediatrics: A complete reference book for parents / L.Sh. Anikeeva ": Moscow: Publishing house" Exmo ".