Siba Prosad Paul and colleagues explain how emergency nurses should manage children with airway compromise or bowel obstruction

Ingestion and aspiration of foreign bodies are common reasons for children presenting to emergency departments. A significant proportion of such events are often unnoticed by the children’s parents or carers. Emergency nurses should become suspicious of foreign body ingestion or aspiration if they see symptoms such as stridor, gagging, wheeze and difference in air entry on auscultation (Hilliard et al 2003, Paul et al 2010). If they suspect airway compromise, or bowel problems such as perforation or obstruction, the children concerned should be dealt with immediately. Definitive management for foreign body removal is generally available at tertiary centres and children should be transferred to specialist services as soon as possible after stabilisation (McConnell 2013). Before discharge, their parents should be educated about possible signs of deterioration and advised about home-safety measures (Paul and Wilkinson 2012).