by Christopher Grindle, MD, reprinted from the American Academy of Otolaryngology
Choking is a leading cause of unintentional injury and death in children; especially those under three years of age. In 2001, 17,500 children under 14 were treated in emergency departments for choking. According to the American Academy of Otolaryngology, choking is the fourth leading cause of death in children behind motor vehicle injuries, drowning and fires. Hazards come in the form of small household items, disk batteries, and even food. In fact 60 percent of the episodes were caused by food items according to reports from the International Journal of Pediatric Otolaryngology.
Often, the risk of choking is either overlooked or underappreciated and therefore not avoided. In light of this, the following are some suggestions to reduce the risk of choking.
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Recognize the problem. The foods that pose the highest risk of a choking hazard according to the American Academy of Pediatrics are: Nuts Seeds Raw Carrots
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Hot Dogs Whole Grapes Popcorn
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Meat and Cheese Chunks Hard Candy Fruit Chunks
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Peanut Butter Chunks Chewing Gum
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Do not feed children younger than four years old round firm food, unless it is chopped completely. Pieces should be no larger than ½ inch (1.27cm). Hot dogs should be cut lengthwise as well as widthwise.
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Do not give peanuts to children younger than seven years old.
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Chewing gum is inappropriate for young children.
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Actively supervise your children while eating. Do not let children run and play while eating.
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Teach your children to chew and swallow food before talking and playing.
Since 1980, the Consumer Product Safety Commission has mandated that all toys that fit within a small parts test cylinder (diameter 1 ¼ inch) must be labeled for children over three years as a choking hazard. It is important to read and pay attention to manufacturers warnings. If you are not certain about a toy, you can purchase a small parts test cylinder, or easier, you can use a toilet paper roll (diameter 1 ¾ inch). If the toy passes easily through the roll, it may pose a choking risk.
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Common household items that pose a choking risk are: Balloons Marbles Small Balls Coins Toys with Small Parts Pen or Marker Caps or Medicine Syringes
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Toys that can fit entirely into your child’s mouth.
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Balloons remain a hazard for children up to eight years of age.
Of particular concern, are small button-type batteries. These are becoming more commonly found, even in greeting cards. They are a problem not only because of their size and shape, but also because of the energy that they discharge when contacting inner body parts. This can lead to damage (erosion or perforation) within two hours of ingestion.
From 1997–2010, an estimated 40,400 children 13 or younger were treated in hospital emergency departments for battery-related injuries. There was a 2.5-fold increase in these cases, from 1,900 in 1998 to 4,800 in 2010. From 1995-2010, there were 14 battery-related deaths, all involving children age four years or less. The risks of battery ingestion are significant and require prompt attention and management.
In summary: Avoidance is the best way to prevent childhood choking.
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Learn CPR (cardiopulmonary resuscitation or basic life support).
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Insist that children eat while sitting down.
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Be aware of older children’s actions – many choking incidents occur because the older sibling unknowingly gave the dangerous food or item to the younger sibling.
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Follow age recommendations on packages.
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Check under furniture and between cushions for small parts that may cause choking.
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Do not let infants and young children play with coins.
Only through a concerted and collaborative effort between parents, teachers and healthcare providers can there be a reduction in choking related injuries and deaths.
At Penobscot Valley Hospital, Brian Miller, MD is an otolaryngologist who sees ENT (Ear, Nose & Throat) patients in the Specialty Clinic located at 252 Enfield Road in the PVH Medical Arts Building. “With some concerted effort, we all can play an important role in reducing childhood choking hazards,” states Dr. Miller. Parents and caregivers wishing to learn child and infant First Aid & CPR techniques should attend the hospital’s two-night course for just $50 on March 4 & 6 from 5-8pm. Call 794-7101 and register today as space is limited.