Did patient eat anything before or during the choking

episode? Food items are the most commonly aspirated foreign bodies in the pediatric population. The foods most often responsible for choking in this age group are hot dogs, grapes, peanuts, and popcorn.

B. Did patient play with any small toys prior to the choking episode? Nonfood items that are aspirated include balloons, toys, and coins. Balloons comprise one third of the foreign bodies that are not food. Many nonfood foreign bodies are nonradiopaque.

C. Does patient have dysphagia? If the foreign body is lodged in the larynx, there could be associated laryngeal swelling compressing the esophagus and leading to dysphagia.

D. Is there a cough? Cough is present in > 90% of cases. It is usually abrupt in onset but can become quiescent after the initial choking episode. Cough can recur if the foreign body is mobile. Persistent cough and fever may indicate a long-standing retained bronchial foreign body.

E. Is stridor present? Stridor suggests upper airway obstruction due to inflammation, infection, or foreign body aspiration.

F. What is the character of the cough? Often if the foreign body is retained in the larynx, there will be a croupy cough and hoarseness. The cough may also be paroxysmal.

G. Does patient have a history of upper airway stenosis? Stenotic lesions from previous intubations or tracheal surgery predispose to specific areas of lodging of the foreign bodies.

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