Management of suspected foreign body aspiration in children1

Abstract

We aimed to establish prevailing consultant opinion on the management of children with a history suggestive of foreign body (FB) aspiration but no clinical or radiological findings. FB aspiration is a common problem in children. Most agree that bronchoscopy should be performed if a child has clinical or radiological signs. With suggestive history but no such signs, the decision is more difficult; both bronchoscopy and neglected FBs have the potential for serious consequences. A postal questionnaire was sent to all British Association of Otolaryngologists and Head and Neck Surgeon (BAO-HNS) consultants. The 563 questionnaires sent elicited a 63% reply rate. With suspected organic FBs, 52% would bronchoscope immediately, 38% would observe, and 10% would discharge. With suspected inorganic FBs, 35% would bronchoscope, 42% would observe, and 23% would discharge. Thus, the majority suggest admission, showing a preference for bronchoscopy with a history of organic FB, and observation if inorganic. Unless justified, it may be unacceptable to discharge these patients.