Dawaa Reference

chronic

Foreign Body in Nose, Larynx, or Bronchus

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Foreign Body Aspiration - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK531480/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class RD36 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (8)

  • Sudden coughing, noisy breathing, wheeze, or gagging should raise strong suspicion [cough · wheeze]
  • The choking person may clutch their own throat with both hands - the universal choking sign
  • Ask about the event: eating or playing with small toys right before symptoms started
  • A history of sudden coughing and choking strongly points to a foreign body [cough · foreign body]
  • Some patients present more than a day after the event, so a recent history is not required to suspect it
  • Complete obstruction is immediately life-threatening; a partial one still blocks gas exchange and brings breathlessness, pneumonia and abscess [abscess · breathlessness]
  • Red flag: loss of consciousness and death come fast, which is why the Heimlich manoeuvre is taught to people who are not clinicians [loss of consciousness]
  • The risk factors are neurological disease, difficulty swallowing, and dental problems - few or no teeth, loose dentures, ill-fitting braces [difficulty swallowing]

Signs — what you find (4)

  • Check skin color, level of alertness, and breathing rate, along with chest retractions and use of extra breathing muscles [chest recession]
  • Stridor and a hoarse voice point to a foreign body lodged in the voice box or trachea [foreign body · hoarseness · stridor]
  • A foreign body in a bronchus can cause wheezing and reduced breath sounds on just one side [foreign body · wheeze]
  • Many patients with a lodged foreign body show none of the classic cough, stridor, or wheeze [cough · foreign body · stridor · wheeze]

Tests (7)

  • A normal chest x-ray does not rule out an inhaled foreign body
  • Neck x-rays (upright, lateral and frontal) are used when the obstruction is thought to be in the upper airway
  • For a lower airway obstruction, chest films taken on breathing in and breathing out are added
  • Most inhaled objects do not show up directly on x-ray, since they are radiolucent
  • Overdistension behind the throat and swelling in front of the spine on the neck film are indirect clues
  • A lower-airway foreign body can show one-sided lung overinflation, collapse, or a shifted mediastinum on chest film
  • Breathing-out films improve detection, since the affected lung stays inflated while air is trapped behind the object

If not this — what else fits (6)

  • Anaphylaxis, blunt or penetrating trauma, a burn injury, or angioedema can cause sudden stridor without fever
  • A febrile child with rapid-onset symptoms raises concern for epiglottitis, bacterial tracheitis, or a retropharyngeal or peritonsillar abscess
  • A gradually developing barking cough points instead to viral croup
  • In infants under six months, structural causes such as laryngomalacia, vocal cord paralysis, or a vascular ring should be considered
  • An esophageal foreign body is more common than an airway one and can also cause breathing trouble from local pressure
  • Swallowing a caustic substance such as detergent can also produce choking symptoms in a toddler

SourceStatPearls "Foreign Body Airway Obstruction" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

An inhaled or inserted foreign object lodged in the nasal cavity or airway, common in young children; a nasal foreign body may sometimes be removed in clinic, but a laryngeal or bronchial foreign body causing airway compromise needs emergency removal, so the GP's priority is rapid recognition and referral. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

An inhaled or inserted foreign object lodged in the nasal cavity or airway, common in young children; a nasal foreign body may sometimes be removed in clinic, but a laryngeal or bronchial foreign body causing airway compromise needs emergency removal, so the GP's priority is rapid recognition and referral.

Cautions
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - Stridor, choking, or acute respiratory distress is an emergency; do not delay for imaging. Refer also for sudden-onset unilateral wheeze or a persistent cough after a choking episode (possible occult bronchial foreign body), or foul-smelling unilateral nasal discharge in a child (possible retained nasal foreign body).

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.