May 21, 2014

Scot: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.
It's hard to believe you would think that parents would be aware of choking hazards, but choking is still the leading cause of unintentional injury and death in children, especially those three years and under, why is that still the case?
We're talking to Dr. Jeremy Meier; he's an EMT Specialist with University of Utah Health Care. Why are so many kids killed by choking still? I would think we would all know the dangers.

Dr. Jeremy Meier: We do, and there's actually been quite a few laws created over the years to try to prevent many of these episodes, and many of the choking hazards. However, kids are still smart, and they're very curious, and they're quick, and fast, and they'll get at things if we leave anything out and in their way, and the oral cavity, and oral stimulation is often where they first learn and so they're curious and want to put things in their mouth.

Scot: Yeah, and anything's fair game when you're a kid, right?

Dr. Jeremy Meier: That's right; especially those things that are shiny and they look enticing.

Scot: Yes, so what constitutes something as a choking hazard?

Dr. Jeremy Meier: Well, if it's small enough to fall into their airway. So usually that's a little over an inch in diameter, I often think of my pinky and if it's smaller than that, then it could easily fall into the airway.

Scot: All right, got you and I was surprised to see that 60% of choking was caused by food. So are there common culprits in the food world?

Dr. Jeremy Meier: Yes, nuts are a big risk factor so children under two should avoid all nuts, peanuts, popcorn kernels can be dangerous, beans, anything small like that that's solid that could easily just slip into the airway. Beans can also be somewhat serious as they, as we've seen where they'll swell inside the airway as they get...and so that can lead to further obstruction, and bigger problems.

Scot: Got you, any other food culprits? I was reading hot dogs, is that true?

Dr. Jeremy Meier: Yes, hot dogs is a big one, out at the picnics, and enjoying the summer afternoon, and those can be a problem as well.

Scot: What about household items? Are there any household items you see a lot?

Dr. Jeremy Meier: Yeah, well, we pull out a lot of coins.

Scot: They're again shiny, right?

Dr. Jeremy Meier: Yeah, and so that cost of a penny was left on the floor then becomes several thousand dollars to the parents.

Scot: Yeah, pretty quickly.

Dr. Jeremy Meier: Right, so coins. We see disk batteries, or button batteries, those can actually be life threatening. If they swallow those, they could stuck in the esophagus and will actually erode through the esophagus and then . . .

Scot: What?

Dr. Jeremy Meier: Yes, and that can happen over minutes to hours.

Scot: Wow so not just a choking hazard, but what else is going on? It's the acid?

Dr. Jeremy Meier: Well the acid, right the acid starts to leak out and it will erode through the esophagus, it's and then it can erode into the carotid arteries and cause major problems.

Scot: What are some other causes of choking that you see?

Dr. Jeremy Meier: Balloons can be a . . . we don't see it because unfortunately most of those kids don't make it to the hospital, if they're...if a young child is blowing on a balloon, or they're sucking on a latex balloon they can inhale that and it can cause sudden death. I've pulled out lots of toys, just random trinkets from kid's airways. I've even had a child that aspirated a safety pin, and it was lodged into the airway and that was a little tricky pulling out.

Scot: Did it open up?

Dr. Jeremy Meier: It was opened up, luckily the sharp point was pointing towards us, but the clasp was hooked into the airway.

Scot: Oh, my goodness.

Dr. Jeremy Meier: So it was a little tricky getting it out.

Scot: So other than keeping you knows things away from kids, are there other ways to prevent choking?

Dr. Jeremy Meier: No, I mean you can't watch your kid 24/7, but just do your best to prevent any loose items from being left around, realize where they are, what is in there sight of view, and just try to avoid any exposures. You know parents may know what is appropriate, but older brothers, or older sisters, may not and they may feel that their younger sibling can play with a toy that they're able to play with and they may leave something out that the younger sibling then goes and grabs.

Scot: Yeah so educate everybody it sounds like, in the house?

Dr. Jeremy Meier: Exactly.

Scot: What about toys? Are those age recommendations legit on toys?

Dr. Jeremy Meier: Yes, they are, and the United States has done a good job of creating guidelines and laws to reduce the risk as much as possible.

Scot: All right let's talk about what happens if you do find your kid choking on an item, what should you do?

Dr. Jeremy Meier: Yeah, I mean that's obviously one of the biggest fears of any parent. It's important to attend to the child first then try to get help as quickly as possible, whether there's someone else around that can call for help, or call 911.

Scot: If a kid's choking, should you just call 911?

Dr. Jeremy Meier: Yeah, that's what I would do.

Scot: Yeah, if it was your child?

Dr. Jeremy Meier: Right.

Scot: What else would you do if it was your child? You've called 911, how do you attend to child? What does that mean?

Dr. Jeremy Meier: The first thing is always the airway and breathing so if the child can, is still able to breath and move air, then you've got some time. If they're not moving any air then you can try the Heimlich maneuver, you can try a finger sweep, but there's unfortunately not a lot. You can try positioning the child upside down, and doing anything to try and dislodge that.

Scot: Is it just a good idea just to try to do anything and everything if they're not breathing because what kind of time do you have at that point?

Dr. Jeremy Meier: Exactly, you don't . . . by the time the EMS would get there you probably would be out of time so just do whatever you can.

Scot: So Heimlich, a finger sweep, and turn them upside down and shake them.

Dr. Jeremy Meier: Exactly, and pound on their back.

Scot: Whatever.

Dr. Jeremy Meier: Right.

Scot: All right, what's the most important thing to keep in mind when it comes to choking in your opinion?

Dr. Jeremy Meier: I would say prevention is the number one priority, keeping things away from your child that are a hazardous choking risk is the best medicine.

Scot: We're your daily dose of science, conversation, medicine. This is The Scope, The University of Utah Health Sciences Radio.

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