(Montreal) Cases of choking serious enough to require a visit to the emergency room and even surgery have been on the rise for fifteen years, suggests a new study published by a team from Laval University and the CHU Research Center from Quebec-Laval University.
Posted at 12:00 p.m.
Jean-Benoit Legault
The Canadian Press
This jump in the number of children admitted to hospital following an episode of choking caused by aspirating food could be attributable to a lack of awareness of the risks posed by certain foods and to parental enthusiasm. for independent eating in children, the authors believe.
“Despite this increase, these are all things that we already knew were dangerous for children, like nuts, seeds and hard vegetables,” said the first author of the study, Dr. Justine Veilleux who was a resident in pediatrics at Laval University under the supervision of Professor Patrick Daigneault at the time of this work.
“So, what we see is that there is perhaps a lack of awareness among the population of good practices in terms of diet to reduce risks. »
The authors of the study examined the files of young people aged 0 to 17 who had been admitted to the Soleil Mother-Child Center of the CHU de Québec-Université Laval between April 2006 and December 2020 following an episode of choking . This hospital center welcomes all children from Eastern Quebec who have had an episode of choking and who present symptoms such as difficulty breathing or a persistent cough.
During this period, just under 200 children with an average age of 31 months underwent an airway examination under anesthesia to determine whether the foreign body was still present and, if so, to remove it.
The number of children requiring a hospital stay following a choking episode exploded by 87% between the first five and last five years of the period covered by the study – a period during which the number of admissions all causes combined at the Soleil Mother-Child Center increased by only 25%.
The foreign body aspirated by the child was a piece of food in three quarters of cases. Carrots and nuts and seeds are practically arriving from the same in first place, with approximately one in five cases. Next are peanuts and popcorn (about one case in ten), then firm fruits or vegetables other than carrots.
In seven out of ten cases, the responsible food was on the list of those to which special attention should be paid because of the risks they present for young children.
A third of the episodes occurred during the weekend, when children spend more time with their parents. The authors of the study also point out that child care professionals may be more aware of the risks of choking and the measures to take to avoid them.
The vast majority of choking episodes, or 85%, occurred at home, eight times out of ten when the child was under the supervision of his parents. In four out of ten cases, the situation was serious enough to justify that a witness to the scene, often a parent, intervened to help the child free his airways.
The intervention ranged from a simple pat on the back to cardiopulmonary resuscitation, “which highlights the importance of educating parents in the proper practice of these maneuvers,” warn the authors of the study.
The authors recorded only one death attributable to a choking episode during their study period, but 10% of patients required intubation and 16% required intensive care.
“Strategies to prevent choking episodes should focus on educating parents about the risks, including foods that are safe to eat at a young age, safe behaviors to adopt while eating, and how to keep small objects out of reach of the child, write the authors. This study highlights the need for better parent education and should encourage clinicians to address the risks of foreign body aspiration with families. »
Researchers believe that part of the measured increase possibly comes from the craze for child-led dietary diversification, an approach that encourages children to play an active role in their diet by eating foods on their own. cut into pieces.
“We cannot say if this method is dangerous or not, but we wonder if there are not parents who practice this method without knowing the foods that are safe or not to offer to children,” commented Doctor Veilleux.
Excluding food, 8% of choking cases were attributable to toys and 17% to various objects.
The authors note that 10% of choking episodes occurred while the child was running. Eight percent of episodes occurred when the child ate something given to them by an individual other than their parent and 13% when the child ate something found on the floor.
More than three-quarters of the patients were under three years old and 65% of them were boys.
“We know that accidents are one of the most significant causes of mortality among children,” recalled Dr. Veilleux. So, when we can prevent and prevent events that harm their health, (we must) intervene to keep children healthy. (And in this case), it’s still something that can be avoided by being careful. »
The findings of this study were published by the Canadian Journal of Respiratory and Critical Care and Sleep Medicine.
