The same things that obstruct an adult’s airway can obstruct the airway of a child.

Foreign bodies or a swollen tongue can cause airway obstruction. Additionally, children are especially prone to aspirate small objects such as peanuts, coins, and small toys.

These objects can cause partial or complete obstruction of the child’s airway. Manage this problem as follows:

a. Try to determine the cause quickly. An accurate history of what is obstructing the child’s airway is essential to clearing the airway.

b. Find out what the child was doing when the emergency occurred.

c. If the child has been ill with a fever, sore throat, or a barking cough, transport him immediately and rapidly to a medical treatment facility. A child whose breathing is causing a harsh, shrill sound (stridor) should also be transported immediately to a medical treatment facility.

d. Take immediate measures to relieve the foreign body obstruction of a child who was previously healthy and who choked while eating or playing with small toys.

e. If the child has good air exchange, encourage him to cough spontaneously.

DO NOT interfere with a child’s attempts to cough out a foreign object.

f. If the child has poor air exchange, ineffective coughing, high-pitched noises on inhalation, increased respiratory distress, and/or cyanosis, manage the condition as if the partial obstruction was a complete obstruction. See the next paragraph.

g. If there is complete airway obstruction (no air exchange at all), treat with a combination of back blows and chest thrusts.

NOTE: For complete information about opening a child’s airway, refer to the booklet “Standards and Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiac Care,” JAMA, Vol. 255, No. 21, June 6, 1986.

CAUTION: DO NOT probe blindly for a foreign object you cannot see.