Ingestion - first aid

Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.

More about the experts All content is checked by medical journalists.

Not paying attention for a moment and you have swallowed a foreign body: With small children it is often things that are put into their mouth out of curiosity (such as Lego bricks, pebbles) and then accidentally slip into the windpipe. Children can also choke on food, such as popcorn or candy. In adults, food also ends up unintentionally in the airways. In the worst case, the person concerned can no longer breathe! Find out everything you need to know about first aid when swallowing foreign bodies!

Brief overview

First aid if swallowed: calm the person affected, ask them to continue coughing, remove any foreign body that has been choked up from the mouth; If the foreign body is stuck, use back blows and, if necessary, Heimlich grip; if breathing has stopped, use ventilation.
Foreign body swallowed - Risks: coughing and gagging, rattling, wheezing or whistling breathing noises, shortness of breath up to respiratory arrest and unconsciousness; If a small foreign body remains in the lungs for a long time, the bronchial tissue can become inflamed.
When to the doctor Call the emergency doctor if the person concerned cannot cough out the foreign body, if back blows and Heimlich grip are unsuccessful, and if the patient no longer breathes or passes out.

Caution!

Do not try to pull the foreign object out of your throat with your fingers. You are more likely to push it in further!
If the victim struggles for breath and / or turns blue, you must call the emergency doctor immediately!
If things that can swell get into the respiratory tract (e.g. seeds), special care is required: the moisture present can increase their volume and then delay breathing.
Those who find it difficult to breathe often instinctively adopt a posture that makes breathing easier. As a first aider, do not change this self-chosen position without need.

First aid if swallowed

If a foreign body is swallowed and gets into the airways (foreign body aspiration), the body tries reflexively to help itself: with coughing and choking, it wants to remove the object from the airways again. But that doesn't always work: First aid is necessary, especially if swallowed heavily. How you do this depends on whether the person can still breathe and cough sufficiently or not:

The affected person can still breathe and cough sufficiently:

Tell him to keep coughing vigorously. The cough is the most effective way of removing the foreign body.
Check to see if the item was coughed up. If so, remove it from your mouth.
If the foreign body is still in the airways, you should inform the ambulance service immediately or ask someone else to do so (Tel. 112).
Calm down the person concerned and ask them to breathe as evenly and calmly as possible. Children may distract you with a story.

The person concerned does not get enough air:

Slap the person on the back several times, moderately between the shoulder blades. You can place a child over your knee or forearm for this. The upper body must hang down. For an adult, do the following: stand behind him, support his chest with one hand and lean him forward a little. Then tap the flat of your hand moderately between the shoulder blades up to five times to trigger a cough reflex.
If five back blows are still unsuccessful, try the so-called Heimlich grip: stand behind the person affected, place a fist between the navel and chest of the person concerned, grasp it with the other hand and pull it backwards five times.
If the foreign body comes up this way, remove it from your mouth.
If the foreign body remains in the airways, call an ambulance immediately or ask someone else to do so.
Until the emergency doctor arrives, you should alternately perform five back blows and five Heimlich grips.

The Heimlich grip can break the affected person's ribs and inflict internal injuries (e.g. rupture of the spleen). Therefore it must not be used in children under one year of age!

The affected person can no longer breathe:

If no breathing sounds or breathing movements can be recognized, you should try to open the airways with the life-saving handle (head slightly overstretched backwards). Exception: You must not overstretch your head with babies! Instead, put it in a normal (neutral) position!
If self-breathing still does not start, you have to ventilate the person concerned (mouth-to-mouth resuscitation).
In the meantime, someone else should call the ambulance if they haven't already.

Foreign body swallowed: Risks

Often the person affected can cough up or choke the foreign body. In such cases, you may still be shocked about the temporary "blockage" of the airways. However, further consequences are usually not to be expected.

The foreign body can also slide into deeper regions of the respiratory tract. This can initially improve breathing - it appears as if the person concerned is recovering. But this condition harbors several dangers:

The foreign body can start moving again at any time and impair breathing elsewhere.
The foreign body can cause severe inflammation in the sensitive bronchial tissue.

Foreign body swallowed: when to see a doctor?

If first aid is ineffective if swallowed, you should call an emergency doctor immediately. Especially if the person concerned can hardly / no breath, there is no time to lose - there is an acute danger to life!

Even if a small foreign body has got into the respiratory tract, but hardly causes any discomfort, you should definitely notify your doctor (risk of slipping, risk of inflammation).

Foreign body swallowed: check with a doctor

If there is no acute shortness of breath, the doctor will first ask the patient or those present (e.g. the first aider) how it was swallowed and what foreign body it is. With the help of a reflection of the airways (bronchoscopy), he can then precisely localize the foreign body in the airways. The patient is usually given an anesthetic for this examination. Then a rigid or flexible tubular tube (bronchoscope) is inserted through his mouth or nose into his windpipe and bronchi. The small camera at the top allows the doctor a look inside the airways.

As an alternative to bronchoscopy, the doctor can also take an X-ray.

Foreign body swallowed: Treatment by the doctor

A foreign body in the airways can usually be removed as part of the bronchoscopy: the doctor uses the tubular bronchoscope to insert tiny medical instruments into the person's airways, with the help of which the foreign body is extracted.

Surgery is rarely necessary to remove a foreign body that has been swallowed. This can be the case, for example, if the foreign body has triggered inflammation in the bronchial tissue. Then it is much more difficult for the doctor to remove it. Often the foreign body is already “baked into” the inflammatory mucous membrane. Then only the surgeon can help.

As soon as the foreign body has been surgically removed, the affected person usually has to remain in the clinic for some time to be observed. He is also given antibiotics for the inflammation.

Follow-up treatment is usually not required. Long-term consequences are usually also not to be feared.

Ingestion: what to do to prevent it?

To prevent your child from swallowing a foreign body, you should take the following tips to heart:

Only let your baby or toddler play with things that are approved for their age and safe.
Pay particular attention to small parts that can become detached from a toy and then often end up in the child's mouth (e.g. glass eyes).
Keep loose buttons, beads, marbles, peanuts, etc. out of the reach of babies and toddlers.
Stay close if your child eats fruit, peas or short pasta that have been cut (too) small.

The following applies to you and other adults:

Do not clamp any small objects between your lips in order to "hold" them when you do not have a free hand (e.g. needles).
Eat slowly and chew each bite thoroughly.
When preparing a fish dish, you should remove any bones as completely as possible. As you eat, pull the fish meat apart with a knife and fork to find any bones left behind. Only then take the bite in your mouth.
Do not gnaw poultry straight from the bone; use cutlery instead. Because poultry bones become brittle through cooking, roasting or grilling - bone fragments are easily formed. If you don't pay attention, you will quickly swallow the foreign body.

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