Best of five
- A. Discharge because imaging is normal
- B. Treat indefinitely as asthma
- C. Induce vomiting
- D. Perform blind finger sweeps
- E. Rigid bronchoscopy when clinical suspicion remains high
FRCS (ORL-HNS) · SECTION 1 SBA
Paediatric airway foreign body
A previously well toddler develops sudden coughing while eating nuts, followed by persistent unilateral wheeze despite a normal chest radiograph. What is the best next action?
E. Rigid bronchoscopy when clinical suspicion remains high
A normal radiograph does not exclude an inhaled radiolucent foreign body. Sudden onset and focal signs justify controlled airway endoscopy by an experienced team.
Why every option is right or wrong
A. Discharge because imaging is normal: Missed foreign body can cause obstruction, pneumonia and bronchiectasis.
B. Treat indefinitely as asthma: Abrupt onset and unilateral findings are atypical.
C. Induce vomiting: This does not retrieve an airway foreign body and risks aspiration.
D. Perform blind finger sweeps: Blind sweeps can push an object distally.
E. Rigid bronchoscopy when clinical suspicion remains high: A normal radiograph does not exclude an inhaled radiolucent foreign body. Sudden onset and focal signs justify controlled airway endoscopy by an experienced team.
What if the scenario changed?
If the child had complete obstruction and could not cough or breathe, immediate age-appropriate choking manoeuvres would precede bronchoscopy.
Independent Clinora educational preparation material; not official JCIE content, an accredited programme, clinical advice, or a substitute for current guidance, local policy and specialist judgement.
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