Aberdeen Voice

By Anne Foy.

Doctors have issued a warning published in a British Medical Journal, that grapes are a ‘choking hazard’ to small children after two Scottish children have died choking on the fruit in the last few years.
45 deaths in Scotland in 2015 among people of all ages were due to choking on food.

Parents already know not to give toddlers under three years old, toys with small parts.

Every mum and dad is well versed on the dangers of marbles and tiny building blocks but foods often aren’t given the same consideration. 

Hotdogs, Grapes and Sweets Risk

The top three foods that children choke on are hotdogs, grapes and sweets because they are exactly the right shape to obstruct an immature airway. Not only do sweets cause dental problems, they are a major choking risk to children. Cherry tomatoes are also a problem and if parents don’t slice them into smaller pieces, they can become lodged in the throat. Babies and under 5 year old’s are at much greater risk of choking accidents because their trachea is so small.

Aberdeenshire Boy Dies

Five year old Aberdeenshire boy, Louis Emaho died in 2012 after choking on grapes at an after-school club. Staff at the club attempted to dislodge the fruit when it became apparent that he couldn’t breathe. He was suctioned by ambulance technicians and given CPR but despite their efforts was dead on arrival at the hospital.

17 Month Old Toddler Dies

In another case, a 17 month old boy died died when he was eating lunch with his family after choking on grapes. His parents attempted to clear his airway but were unsuccessful so they dialled for an emergency ambulance. Initial attempts at CPR failed because the fruit was still blocking the airway so paramedics met the ambulance crew on route to the hospital and were able to remove it via laryngoscopy (a telescope that allows the doctor to see into the back of the throat and extract objects). 

Medical staff were unable to revive the little boy.

A Lucky Escape

A third child narrowly escaped death when he began choking on grapes in the park. An ambulance crew was already nearby and were on the scene within minutes. They were able to remove the grape and the child began breathing again, although he had two seizures as a result of the oxygen starvation and signs of brain swelling. After being placed on artificial ventilation for five days. Just six days following the removal of his vent, he was well enough to go home. Miraculously, he showed no signs of any disability.

Advice for Parents

Due to these infrequent but tragic incidents, NHS Health Scotland has updated their childcare guidance and now suggest that parents chop up fruits like cherry tomatoes and grapes into tiny pieces, remove any pips and stones and avoid whole nuts. They also advise that it is safer to cut larger fruits into slices rather than chunks, as this makes them thinner and less likely to get stuck in the throat and they urged that parents supervise their young children when they are eating.

What To Do If Your Child Chokes

• Check your child’s mouth for blockages and remove any you can see. Don’t poke your fingers down their throat or you could push it down even deeper and make the situation worse.
• If your child can’t cough due to the blockage, place him face down across your lap and slap him in the middle of his back between his shoulder blades, five times in succession. If he is a baby under one year, make sure you support his head with your other hand.
• If the blockage isn’t dislodged, begin chest thrusts. In an older child, you can do this by kneeling behind him and putting your arms around his upper waist, under his arms. Make a fist and place it between the ribs and the navel, then place your other hand over your fist and make a forceful inwards and upward thrust. Do this five times and then check your child.
• Babies need a different type of thrust. If your baby is under one year, you can perform chest thrusts by placing him face up on your lap, along your thighs and put two fingers in the middle of his breastbone. Push sharply five times in succession. 
• If your child has lost consciousness, dial 999 and use speakerphone so that you can still do back thrusts or CPR until help arrives.

References:

• The choking hazard of grapes: a plea for awareness, The Archives of Disease in Childhood, Amy J Lumsden anhttp://www.writingcontent.co.uk/submit_task.php?task_id=26262d Jamie G Cooper, doi:10.1136/archdischild-2016-311750
• Grape choking warning to parents after deaths of young boys, STV News, December 21, 2016.
• Healthy Snack Ideas, Child Smile, NHS Scotland. Accessed December 21, 2016.
• Dental Insurance, Q, Accessed December 21, 2016.
• How to Help a Choking Child, NHS Choices, Accessed December 21, 2016.
• Accidental Deaths, National Records of Scotland, Accessed December 21, 2016. 

Picture courtesy of Selovekt used under Creative Commons license.

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