Foreign Body Aspiration (FBA) - the accidental inhalation of objects into the airway - is a peril that often flies under the radar of public health discourse. Yet, its impact on global health is far from negligible. From a child's impulsive swallowing of a small toy to an adult's mishap with a poorly chewed piece of food, foreign body aspiration can affect individuals across all age groups. Its consequences range from mild discomfort to life-threatening emergencies, often requiring immediate medical intervention.

Causes Of Foreign Body Aspiration

Foreign Body Aspiration might be caused due to the following reasons:

Accidental ingestion: Most common in children, especially those under 3 years old, who may put small objects in their mouths.
Eating habits: Rapid eating, talking while eating, or laughing during meals can lead to aspiration.
Impaired swallowing: Conditions like stroke, Parkinson's disease, or dementia can affect swallowing reflexes.
Dental procedures: Accidentally inhaling dental materials or broken teeth.
Occupational hazards: Workers in certain industries may inhale small particles or objects.

Symptoms of Foreign Body Aspiration

Following symptoms prevail indicating possibilities of Foreign Body Aspiration:

Sudden onset of coughing, choking, or gagging
Wheezing or noisy breathing
Difficulty breathing or shortness of breath
Chest pain
Cyanosis (bluish discoloration of the skin)
In severe cases, loss of consciousness

Complications in of Foreign Body Aspiration

This condition presents some complications, such as:

Pulmonary Infections: Pneumonia or lung abscesses are common complications if the foreign body remains in the airway.
Airway Secretions: Retained secretions can create an environment for bacterial overgrowth.
Hyperinflation: Can occur if the foreign body is not removed, leading to further complications.
Complications from Intervention: Risks include damage to teeth, mouth, oesophagus, bronchial tree, vocal cords, pneumothorax, atelectasis, stricture, and perforation.

Diagnosis of Foreign Body Aspiration

The diagnosis of Foreign Body Aspiration includes the following procedures:

Physical examination: Listening to breath sounds and checking for signs of respiratory distress.

Chest X-ray: To visualise the foreign body if it's radiopaque.
Computed Tomography (CT) scan: For more detailed imaging, especially for radiolucent objects.
Bronchoscopy: Both diagnostic and therapeutic, allowing direct visualization and potential removal of the foreign body.
Laryngoscopy: To examine the larynx and upper airway.

Treatment of Foreign Body Aspiration

The treatment for foreign body aspiration depends on the severity of the blockage and the size and location of the object.

For mild cases:

Coughing: This is the body's natural way of trying to expel the object.

For moderate cases:

Heimlich manoeuvre: This is a series of abdominal thrusts that can help to dislodge an object from the airway.
Back blows: These are blows delivered between the shoulder blades that can also help to dislodge an object.

For severe cases:

Bronchoscopy: This is a procedure that uses a thin, lighted tube to look into the airways and remove the object.

Important to remember:

Do not attempt to remove a foreign object from the airway if the person is choking severely.
Do not perform the Heimlich manoeuvre on a pregnant woman or a very obese person.

Prevention

To manage and prevent any cases of foreign body aspiration, individuals must follow these:

Supervision: Close monitoring of young children, especially during meals and playtime.
Education: Teaching children about the dangers of putting non-food items in their mouths.
Safe eating habits: Encouraging thorough chewing and avoiding talking or laughing while eating.
Proper food preparation: Cutting food into small, manageable pieces for young children and the elderly.
Occupational safety: Implementing safety measures in workplaces where inhalation risks exist.
Regular dental check-ups: To address loose teeth or poorly fitting dentures.
Management of underlying conditions: Proper care for neurological conditions that affect swallowing.

By understanding these aspects of Foreign Body Aspiration, individuals, caregivers, and healthcare professionals can better prevent, recognise, and manage this potentially life-threatening condition. Early recognition and prompt action are key to reducing the morbidity and mortality associated with FBA.

Reference links:

https://www.ncbi.nlm.nih.gov/books/NBK531480/
https://shc.amegroups.org/article/view/6248/html
https://www.indianpediatrics.net/nov2002/nov-1006-1010.htm