Four-year-old chokes on seed, survives cardiac arrest

A four-year-old boy was admitted to Jehangir hospital for choking recently as he swallowed an unknown foreign body while playing. By the time he reached the hospital, he had a cardiac arrest. And he suffered the second cardiac arrest while doctors were treating him.

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Can you imagine a child whose heart completely stops on two occasions, but the child goes home hale and hearty?

A four-year-old boy was admitted to Jehangir hospital for choking recently as he swallowed an unknown foreign body while playing. By the time he reached the hospital, he had a cardiac arrest. And he suffered the second cardiac arrest while doctors were treating him.

It became obvious that something was stuck in his wind-pipe. So as an emergency measure, a tube was inserted into his main wind-pipe so as to push the foreign body to one side. That enabled at least one lung to start functioning. He required resuscitation including cardiac compression and injecting adrenaline after which he recovered. Soon he regained consciousness.

He underwent a diagnostic Bronchoscopy by Dr. Dasmit Singh, who confirmed the presence of a very hard foreign body on one side which had caused severe inflammation and swelling of the lining of the bronchus. The foreign body was jammed and could not be dislodged.

On July 3, when he was to be shifted for surgery, his oxygen in the body dropped significantly and he desaturated. His heart slowed down and he went into cardiac arrest. He was resuscitated and stabilized by Dr. Sagar Lad and his PICU team.

This time the foreign body had not budged from its position, but even then the child got a cardiac arrest. The child was taken then in the operation theatre. Paediatric Anaesthesia team was consulted on whether the child would be able to withstand Anesthesia. They agreed to take the risk and go ahead.

Dr Singh then performed a Bronchoscopy, but it was impossible to dislodge the foreign body. The next option that was resorted to was to open the chest. An opening was made in the Bronchus. At this time it became very difficult to ventilate the baby because most of the anesthesia gases and Oxygen would leak out from the opening. Doctors mentioned that this time speed was of the essence.

Dr Singh said, “The FB could be successfully grasped and removed. It was so swollen up that even removing with open surgery was quite difficult.  The procedure met with success. He was shifted to the ward and subsequently discharged.”

He added, “No child under the age of 3 years should be given small things as they can get aspirated into the wind-pipe. Also one should ensure no child should be jumping and eating at the same time.If any child gets a sudden bout of cough while eating, the possibility of FB aspiration must be kept in mind and the child rushed to a hospital with adequate facilities of a fully equipped PICU and Pediatric Surgical facilities.”