foreign bodies, ingested

Kids swallow the darndest things, to paraphrase Art Linkletter. Small and not so small children have a tendency to put foreign objects in the mouth. A good general rule is that all such ingestions should be taken seriously, at least until things are clarified. Some naturally smooth, round objects present little difficulties; "This too shall pass." Other objects may not be so benign. Exactly how to manage any given ingestion may be an area of medical uncertainty. Whenever there is any doubt whatsoever, your child's physician should be consulted immediately.

With any such ingestion the first concern is the child's ability to breathe - is there any sign of respiratory difficulty. If so, immediate emergency care is required - get someone to call 911 while you attempt to clear the child's airway. Inspect the mouth for signs of the foreign object, and perform the Heimlich manuever if you have been trained to perform it correctly.

If you have not had a CPR course - now is a good time to think of taking one. Insist that your babysitter have taken a Safe Sitter course as well - many hospitals offer them.

Assuming that your child is breathing fine, it is time to call your doctor for some instructions.

Some of the almost limitless number of possibilities:

watch batteries Management of these ingestions has historically been the subject of some debate. The batteries contain very corrosive chemicals, and if the battery ruptures, the result can be very bad. Depending upon where the battery is, management varies. If the battery is lodged in the esophagus, there is a risk of perforation of the esophagus. Such an ingested battery is removed endoscopically as soon as possible. Once the battery is through the esophagus into the stomach and beyond, it is usually watched to make sure it passes on through the digestive tract promptly.
pins, needles, and sharp objects These can potentially perforate the esophagus or bowel, again with major complications. Localization in the body is by xray and further medical management is definitely warranted.
coins A coin can become lodged in the area of the larynx or in the lower esophagus just above the stomach, but more usually it passes into the stomach. Once there, the next obstacle is the valve from the stomach to the small intestine (the pyloric valve). Once the coin passes through this restriction, it is generally clear sailing on out of the GI tract.
marbles, pebbles and other smooth, round objects Rarely present much trouble; they slide right on through the gut.
insects While the very idea may give you the creepies, ingested insects are not generally harmful. The pillbug or sowbug is a common bug for toddlers to ingest.

Above all, remember to notify your child's physician for any foreign body ingestion.

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