As part of a Choking Prevention and Quality Improvement Initiative, we would like to inform physicians that:
• Any patient who presents with coughing and/or wheezing after oral exposure to a high-risk object (such as a nut or nut fragment, piece of raw carrot, apple or pear, unpopped popcorn kernel, seed, dried bean, plastic toy part, thumbtack, or pin) should be considered to have a bronchial foreign body until proven otherwise.
• For patients with a round metallic disc in the esophagus, a disc battery must be urgently ruled out.
• To prevent complete laryngeal obstruction, hotdogs and grapes should be cut lengthwise into quarter sections until a child is at least 5 years old and has no development delay in terms of swallowing. Deflated balloons and gel candies (a.k.a. “fruit poppers;” available in many Asian markets) should be kept out of reach of young children. Please advise parents of these issues.