Find out what to do in cases of bronchoaspiration – 12/13/2023 – Balance

Girl Ayla, 4, daughter of model Bárbara Evans, gave the family a scare. Because of a peanut, the child had to undergo a bronchoscopy. Evans reported what happened on social media.

The model said that her daughter choked while eating shelled peanuts. She coughed, vomited, and wheezing appeared in her breathing, in addition to coughing. The condition persisted for about three days. At least two doctors attended to her and did not discover the cause. It was the girl’s pediatrician who made the correct diagnosis after seeing the X-ray.

Ayla was the victim of bronchoaspiration, a condition in which a liquid or solid material enters the airway.

“In our swallowing mechanism, this material goes from the mouth to the pharynx and esophagus. When there is bronchoaspiration, it goes from the pharynx to the trachea. This is the aspiration mechanism”, explains Diego Henrique Ramos, pulmonologist at Hospital São Luiz Itaim , from Rede D’Or.

In Ayla’s case, the peanut reached her lung. With bronchoscopy, doctors removed 95% of the food. The remainder will be eliminated naturally.

“It’s a medical emergency situation. Depending on the size and type of object or food, it can partially or completely obstruct breathing. In some cases, it leads to death,” says Ramos.

The problem is not exclusive to children. It can occur in the elderly, but the reasons are different.

Generally, elderly people have bronchoaspiration due to issues linked to chronic neurological disease, post-stroke (Cerebral Vascular Accident) or a patient with Parkinson’s disease has a higher risk of aspiration. In children, sometimes there is incoordination in swallowing and they aspirate.

Signs of bronchoaspiration

The first sign is an intense and persistent dry cough followed by shortness of breath, chest pain and discomfort after trying to swallow. Typically, the child chokes. “In case of suspicion, the person must be helped by the rescue service or taken to the nearest emergency room”, advises Ramos.

According to pediatric pulmonologist Marina Buarque de Almeida, president of the Department of Pulmonology at the São Paulo Society of Pediatrics, if it is a severe obstruction the child turns purple and loses consciousness.

“And you only have a few minutes to help. I don’t know if you remember the Soft bullet. If the person got scared with the bullet in their mouth and inhaled it, they would die, because the bullet closed the air passage”, comments the doctor.

How to avoid bronchoaspiration

The pulmonologist states that children under 4 years of age should not have access to foods such as cherry tomatoes and grapes – unless they are well cut.

“Aspiration is also common with walnuts, almonds and peanuts. When offering these seeds, it should be in crushed or macerated form. Another thing that can happen is the aspiration of toys. Therefore, there are a number of prohibited toys for certain ages, such as Hot Wheels cars, where the wheel can come off. They are recommended from 3 years old”, says the pulmonologist.

Popcorn is another danger because it causes choking very easily. For children under 3 years old, the ideal is to opt for sago popcorn. “It doesn’t have the hard part of corn, which can lead to choking,” says the doctor.

Another thing to pay attention to is a vegan diet. “There is a recommendation to give seeds to children. I had a patient who had recurrent aspiration with sunflower seeds, she went for emergency bronchoscopy, a very serious condition. We saw that she had already aspired to other parts of the lung, other times. seeds must be crushed”, highlights Marina Buarque de Almeida.

“The problem with peanuts and oilseeds is that, when you inhale them, they end up in your bronchi and cause inflammation, significant edema. It causes a very intense wheezing crisis, acute pneumonia. Depending on where this food ends up, it can until it is fatal”, concludes the doctor

Pulmonologist Diego Henrique Ramos also reinforces that it is necessary to supervise children and the elderly with chronic neurological diseases during meals.