> If your child is having trouble breathing or respiratory difficulty call an ambulance.
> If you child look fine otherwise, call your child's clinician.
> Depending on the type of foreign body swallowed and the symptoms, your clinician might request an X ray.
> If your child is having symptoms and the X ray is normal, your clinician might request for Barium swallow or endoscopy.
> If the foreign body is high in the esophagus or it is a battery or sharp object, immediate endoscopy is needed.
> If a smooth object or food impaction is in the middle or distal esophagus and you child is free of symptoms, he or she can be observed for 12 to 24 hours (in consultation with a gastroenterologist) and removed if it is not passed down. Get a repeat X ray immediately before removal.
> If the foreign body is in the stomach and beyond, your child can observed with serial X rays as an out patient.
> If there is fever, vomiting, belly pain, and blood in the stool, your child should be seen by your clinician or go to the ER.
Adapted from: CONTEMPORARY PEDIATRICS Nov 2006, page 38
Most coins will go down and cause no problems. However, you should call your child's clinician for follow up.
Leo Leonidas, MD, FAAP, Bangor, Maine, USA