Put your coins away

Tuesday, June 4, 2013

Put your coins away

Hey! Yep, I'm still alive. Junior internship has been eating most of my time. I just finished my ENT rotation a week ago. It was my first rotation that had an ER post. And, let me tell you this, ENT is where they will point you when you've swallowed a foreign body accidentally (or on purpose).

Of all the cases that I've encountered in the ER, more than a dozen were foreign body ingestions. And all of those patients were kids. Apparently, kids, 1-3 year olds, like to swallow 1-peso coins before bedtime since they always show up at the ER at 10pm-12am. Studies have shown that coins are the most common culprit in foreign body ingestion in kids. 

Now where does the coin go? There are 2 possible areas - the airways or the esophagus. You'll know it's lodge in the airways because your child will be gasping for air. If it's in the esophagus then the child may present with drooling, gagging, vomiting and food refusal. Sometimes, it may even show you no symptoms. Scary, right? An x-ray is a must to localize the coin. 

Can you guess where the coin is?

If a coin gets stuck in the esophagus, it can cause esophageal erosions or tissue injury. Although it can pass to the stomach and eventually to the intestines, it's still best to be sure. If the coin gets stuck in the esophagus then endoscopy must be done which will require your child to be under general anesthesia. 

Be it in the airway or the esophagus, foreign body ingestion is a medical emergency. If you suspect foreign body ingestion, bring your kid to the nearest ER. 

I'm telling you this because ER doctors want to rest at night too. But kidding aside, wouldn't it be such a bummer to have a trip to the ER just because of a measly one-peso coin? Aside from the stress that it will bring you and your child, that one-peso coin can also cost you thousands of pesos. 

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