# Foreign Body in Nose, Larynx, or Bronchus - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - 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 date: 2026-08 ## Verified against - No dose - referral pathway, no medicine given in primary care ## Treatment metadata - No drug therapy in primary care (Referral & Advice) ## Complete treatment card ```text FOREIGN BODY IN NOSE, LARYNX, OR BRONCHUS 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 Review status: REVIEWED against the source listed above (2026-08) 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 Source StatPearls "Foreign Body Airway Obstruction" - disease-level clinical article Status traced to the source above 1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE) [1st line] Adult 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 Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. 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. Caution 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. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)