EVALUATION OF THE NEW SCORING SYSTEM FOR THE MANAGEMENT OF SUSPECTED FOREIGN BODY ASPIRATION IN CHILDREN

Abstract

IntroductionForeign body aspiration (FBA) is encountered in many instances in the pediatric emergency department that could be life-threatening. FBA is considered the fifth cause of accidental death in children aged one to three years and the third cause of accidental death in children below one year. Diagnosis of FB aspiration is achieved by good history taking, clinical examination and chest radiography. In most cases, the witnessed event of aspiration is the most sensitive diagnostic tool. There is a wide range of clinical presentations in children with suspected FBA such as cough, dyspnea, wheezing, cyanosis and stridor. It also may be asymptomatic. FBA can lead to partial or complete air way obstruction, resulting in serious complications such as pneumonia, atelectasis, bronchiectasis, lung abscess , or even death. Bronchoscopy, whether rigid or flexible, is the standard procedure to ascertain and manage FBA. The use of flexible or rigid bronchoscopy has been a matter of debate for a few decades . In 2021, a retrospective cohort study was published to establish a management protocol for children with suspected FBA. Based on a simple algorithm, including history taking (witnessed choking, sudden cough and new-onset or recurrent wheezes), physical examination (unilateral decrease air entry, wheezy chest, respiratory distress) and radiological finding (unilateral hyperinflation). This approach may assist physicians to determine which cases require bronchoscopic interventions and which cases to follow up.