Doctors issue choking warning

‘DIFFICULT BREATHING’::After three children in Kaohsiung went to the hospital while choking on nuts, doctors advised parents to cut these types of foods into small pieces

By Fang Chih-hsien and Dennis Xie  /  Staff reporter, with staff writer

Tue, Oct 29, 2019 - Page 2

After three children in Kaohsiung nearly died, doctors advised that foods such as peanuts, melon seeds and nuts should be cut into pieces before feeding to children to avoid choking.

Hsu Mei-hsin (徐美欣), a doctor at Kaohsiung Chang Gung Memorial Hospital’s pediatric intensive care unit (PICU), on Sunday said the hospital has recently treated three children who developed acute respiratory distress because of peanuts stuck in their airways.

All three patients had to undergo surgery to remove the foreign bodies, Hsu said.

PICU director Kuo Hsuan-chang (郭玄章) said that in the first case, a peanut accidentally entered the trachea and obstructed the passageway of a three-year-old, who then had trouble breathing.

The child was rushed to the hospital, and an emergency tracheal intubation was performed, but the child had already gone into cardiac arrest, he said.

The peanut in the trachea then broke into two pieces and fell into the right main bronchial tube, causing the right lung to collapse. During surgery, other pieces entered the main bronchial tube again, causing the left lung to collapse as well, Kuo said.

All the peanut pieces were removed eventually, but the patient went into a vegetative state due to a lack of oxygen to the brain, he said.

Hsu said that in the other two cases, peanuts went down the trachea and also entered the bronchial tubes.

In the second case, a five-year-old ate peanuts while his parents were not watching, and then began to experience difficult and rapid breathing. Suspecting that it might be an asthma attack, the parents brought the child to the hospital for asthma treatment, but to no avail, she said.

It was only upon further examination that a peanut was found lodged in the bronchial tube. Because it passed the trachea and entered the bronchial tube, the patient was able to continue to breathe, although with difficulty, Hsu said.

In the third case, a peanut was lodged in the bronchial tube of a one-year-old, who soon showed symptoms resembling an asthma attack, she said.

Doctors responded quickly and removed all the peanut pieces after the parents mentioned that the child had been eating peanuts, she said.

However, some broken pieces at the bottom of the lungs had already caused an inflammation of the bronchial tube, requiring further observation at the ICU before the child could return home, she added.

Hsu said peanuts are the most common cause of children choking, while melon seeds, melon seed shells and nuts are also common culprits. She added that a child’s trachea is about the size of a peanut.

As peanuts break easily, some pieces might break off during surgery and find their way to the lungs, causing difficulty breathing and pneumonia, she said.

Pediatric intensive care department director Lin Ing-jui (林盈瑞) said that foreign objects enter young children’s tracheas more easily due to their limited chewing and swallowing abilities.

Parents should be aware that something might be blocking the child’s airway when they experience symptoms similar to asthma that do not improve after taking asthma medications, Lin said.

People should keep foods of this type out of children’s reach, he said, adding that cutting these foods into small pieces before consumption would be a safer approach.