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Choking can be a mouthful

Parents have had a mouthful of questions recently about what to do if their child has accidentally swallowed a coin. Let me see if I can make some cents out of what to do if this happens. Coins are the most common object swallowed by a child. But in the vast majority of cases, once a quarter or anything smaller reaches the stomach, it passes through the intestines and eventually comes out, usually within a week or two of swallowing it. So when is this really a problem? First and foremost, if your child is choking on the coin either during or after swallowing it, the coin is probably lodged either in the food pipe, which we call the esophagus, or the wind pipe, known as the trachea. In either case, if your child is still able to talk and breathe, he or she is likely to cough the coin up or pass the coin onward through the intestines and will usually recover unassisted. But if your child is unable to talk or breathe, is gasping, becomes blue in the face, grabs at his or her throat and appears panicked, then the Heimlich maneuver which is a part of CPR training is required. The Heimlich maneuver allows you to push air upward from just below the ribs through the windpipe to dislodge the object your child is choking on. If you have not learned how to do the Heimlich maneuver, and no one else is around to perform it, call 911 for help so that you can get instructions for doing it while an ambulance is on the way. If your child shows no signs of distress after swallowing a coin, please talk to your childs doctor anyway he or she may want to get an x-ray after 24 hours to make sure the coin has at least made it to the stomach. If it doesnt get there by the time the x-ray is taken, it may need to be removed with a special instrument but this is rare. Of course, the best approach is to prevent incidents like this by keeping foreign objects out of your childs reach. Hopefully, tips like this will change things for the better when it comes to making sure that if your child accidentally swallows a coin, everything comes out fine in the end. Lewis First, M.D., is chief of Pediatrics at Vermont Childrens Hospital at Fletcher Allen and chair of the Department of Pediatrics at the University of Vermont College of Medicine. You can also catch First with Kids weekly on WOKO 98.9 FM and WCAX-TV Channel 3. Visit the First with Kids archives at www.vermontchildrens.org.

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