Brief overview
- First aid in case of swallowing: Reassure victim, ask to continue coughing, remove any foreign body that has been regurgitated from the mouth; if foreign body is stuck, apply back blows and Heimlich grip if necessary, ventilate in case of respiratory arrest.
- When to go to the doctor? Call emergency medical services if the patient is unable to cough out the foreign body, if back blows and Heimlich grips are unsuccessful, and if the patient stops breathing or becomes unconscious.
Caution.
- Do not try to pull the foreign body out of the throat with your fingers. You are more likely to push it in further!
- If the affected person struggles to breathe and/or turns blue, you must call the emergency medical services immediately!
- People who have difficulty breathing often instinctively adopt a posture that makes breathing easier. As a first-aider, do not change this self-chosen position without necessity.
First aid for swallowing
The affected person can still breathe and cough sufficiently:
- Prompt him to continue coughing vigorously. Coughing removes the foreign body most effectively.
- Check to see if the object has been coughed up. If so, remove it from the mouth.
- If the foreign body is still stuck in the airway, you should immediately call the emergency medical services or ask someone else to do so (tel. 112) while you remain with the victim.
The affected person gets bad air:
- If five back blows have not been successful, try the Heimlich grip: stand behind the patient, place one fist between the navel and the patient’s chest, grasp it with the other hand and pull it backwards and upwards five times with a jerk.
- If the foreign body comes up in this way, remove it from the mouth.
- If the foreign body remains in the airways, immediately notify the emergency medical services or ask someone else to do so.
Heimlich grip can break ribs and cause internal injuries (e.g. rupture of spleen). Therefore, it must not be used on children under one year of age!
The victim can no longer breathe:
- If the patient’s own breathing still does not start, you must begin cardiopulmonary resuscitation (mouth-to-mouth resuscitation).
- In the meantime, someone else should call the rescue service if this has not already been done.
Foreign body swallowed: risks
However, the foreign body can also slip into deeper regions of the respiratory tract. This can initially improve breathing – it seems as if the affected person is recovering. But this condition poses several dangers:
- The foreign body can start moving again at any time and interfere with breathing elsewhere.
- The foreign body can cause severe inflammation in the sensitive bronchial tissue.
Foreign body swallowed: When to see a doctor?
Even if a small foreign body has entered the respiratory tract, but causes hardly any discomfort, you should definitely notify the doctor (risk of slipping, risk of inflammation).
Foreign body swallowed: examinations by the doctor
If there is no acute respiratory distress, the doctor will first ask the patient or others present (e.g. the first aider) how the swallowing occurred and what foreign body it is.
As an alternative to bronchoscopy, the physician can also X-ray the affected person.
Foreign body swallowed: treatment by the doctor
In most cases, a foreign body in the airways can already be removed during bronchoscopy: the doctor inserts tiny medical instruments into the affected person’s airways via the tube-shaped bronchoscope and uses them to extract the foreign body.
Once the foreign body has been surgically removed, the affected person must usually remain in the clinic for some time for observation. He also receives antibiotics against the inflammation.
Follow-up treatment is usually not necessary. Late effects are also not to be feared in normal cases.
Ingestion: What to do for prevention?
To prevent your child from swallowing a foreign body, you should take the following tips to heart:
- Pay particular attention to small parts that can detach from a toy and then often end up quickly in the mouth of your offspring (e.g. glass eyes).
- Make sure loose buttons, beads, marbles, peanuts, etc. are out of reach of babies and toddlers.
- Stay close by when your child is eating (too) small cut fruit, peas, or even short pasta.
For you and other adults:
- Eat slowly and chew each bite thoroughly.
- When preparing a fish dish, remove existing bones as completely as possible. Pull the fish flesh apart with a knife and fork as you eat to discover any remaining bones. Only then put the bite in your mouth.
