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Lorenzoni G, Vertuani M, Basso V, Rescigno P, Ocagli H, Gregori D. Characterization of Non-Food Foreign Bodies Aspirated by Children: A Systematic Review of the Literature. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1709. [PMID: 37892372 PMCID: PMC10605452 DOI: 10.3390/children10101709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/14/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Foreign Body Aspiration (FBA) represents a leading cause of death among unintentional injuries in children less than one year of age. This study reviewed case reports and case series reporting non-food FBA in children to characterize aspirated foreign bodies, describing the clinical presentations and the outcomes. METHODS A systematic review was conducted according to the PRISMA checklist. Case reports and case series presenting non-food FBA in children (up to 18 years) were eligible to be included. Information regarding study characteristics, child demographics, foreign body characteristics, clinical presentation, and outcome were extracted. RESULTS The review included 248 articles published between 1965 and 2023, corresponding to 294 cases. The male gender was the most prevalent (194 cases, 66%), and the median age was 3.5 years (Interquartile Range: 1-8 years). Button batteries were the objects most frequently reported (21 cases, 7.1%). Objects were located most often in the bronchus (102 cases, 35%). The most common symptom was cough (181 cases, 62%), followed by respiratory distress (160 cases, 54%) and wheezing/stridor (127 cases, 43%). CONCLUSIONS The present systematic review may have relevant public health implications, since characterizing objects that cause foreign body injuries is essential to reduce the burden of this phenomenon.
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Affiliation(s)
| | | | | | | | | | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, 35131 Padova, Italy; (G.L.); (M.V.); (V.B.); (P.R.); (H.O.)
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Cardalda-Serantes B, Carballo-Fazanes A, Rodríguez-Ruiz E, Abelairas-Gómez C, Rodríguez-Núñez A. Would anti-choking devices be correctly and quickly managed by health science students? A manikin crossover trial. BMC MEDICAL EDUCATION 2023; 23:365. [PMID: 37221498 DOI: 10.1186/s12909-023-04345-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 05/10/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND The brand-new anti-choking devices (LifeVac® and DeCHOKER®) have been recently developed to treat Foreign Body Airway Obstruction (FBAO). However, the scientific evidence around these devices that are available to the public is limited. Therefore, this study aimed to assess the ability to use the LifeVac® and DeCHOKER® devices in an adult FBAO simulated scenario, by untrained health science students. METHODS Forty-three health science students were asked to solve an FBAO event in three simulated scenarios: 1) using the LifeVac®, 2) using the DeCHOKER®, and 3) following the recommendations of the current FBAO protocol. A simulation-based assessment was used to analyze the correct compliance rate in the three scenarios based on the correct execution of the required steps, and the time it took to complete each one. RESULTS Participants achieved correct compliance rates between 80-100%, similar in both devices (p = 0.192). Overall test times were significantly shorter with LifeVac® than DeCHOKER® device (36.6 sec. [31.9-44.4] vs. 50.4 s [36.7-66.9], p < 0.001). Regarding the recommended protocol, a 50% correct compliance rate was obtained in those with prior training vs. 31.3% without training, (p = 0.002). CONCLUSIONS Untrained health science students are able to quickly and adequately use the brand-new anti-choking devices but have more difficulties in applying the current recommended FBAO protocol.
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Affiliation(s)
- Borja Cardalda-Serantes
- Anesthesiology and Intensive Care Medicine Department, University Clinic Hospital of Santiago de Compostela (CHUS), Galician Public Health System (SERGAS), Santiago de Compostela, Spain
| | - Aida Carballo-Fazanes
- CLINURSID Research Group, University of Santiago de Compostela, Santiago de Compostela, Spain.
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin (RICORS), Instituto de Salud Carlos III, RD21/0012/0025, Madrid, Spain.
- Simulation, Life Support, and Intensive Care Research Unit (SICRUS), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
| | - Emilio Rodríguez-Ruiz
- CLINURSID Research Group, University of Santiago de Compostela, Santiago de Compostela, Spain
- Simulation, Life Support, and Intensive Care Research Unit (SICRUS), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Intensive Care Medicine Department, University Clinic Hospital of Santiago de Compostela (CHUS), Galician Public Health System (SERGAS), Santiago de Compostela, Spain
| | - Cristian Abelairas-Gómez
- CLINURSID Research Group, University of Santiago de Compostela, Santiago de Compostela, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin (RICORS), Instituto de Salud Carlos III, RD21/0012/0025, Madrid, Spain
- Simulation, Life Support, and Intensive Care Research Unit (SICRUS), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Faculty of Education Sciences, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Antonio Rodríguez-Núñez
- CLINURSID Research Group, University of Santiago de Compostela, Santiago de Compostela, Spain
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Developmental Origin (RICORS), Instituto de Salud Carlos III, RD21/0012/0025, Madrid, Spain
- Simulation, Life Support, and Intensive Care Research Unit (SICRUS), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Intensive Care Medicine Department, University Clinic Hospital of Santiago de Compostela (CHUS), Galician Public Health System (SERGAS), Santiago de Compostela, Spain
- Pediatric Critical, Intermediate and Palliative Care Section, Pediatric Department. Hospital, Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
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Lorenzoni G, Hochdorn A, Beltrame Vriz G, Francavilla A, Valentini R, Baldas S, Cuestas G, Rodriguez H, Gulati A, van As ABS, Gregori D. Regulatory and Educational Initiatives to Prevent Food Choking Injuries in Children: An Overview of the Current Approaches. Front Public Health 2022; 10:830876. [PMID: 35664124 PMCID: PMC9160792 DOI: 10.3389/fpubh.2022.830876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/11/2022] [Indexed: 12/04/2022] Open
Abstract
Choking injuries are one of the major causes of death among children ages 0-3, and most of these injuries are related to food. This work provides an overview of the current recommendations for food choking prevention and educational targets as a basis for developing a unified common set of knowledge for primary prevention policies development. Guidelines published by professional membership organizations and national governments in the English language were considered. All of these guidelines provide lists of hazardous food items and recommendations for food preparation to minimize choking hazard. Together with recommendations for food preparation, also recommendations aimed at stakeholders (food manufacturers, health care providers, and public authorities) are provided, underlining that this severe public health problem should be further addressed by adopting integrated public health interventions. Our overview stressed the importance of developing educational and primary prevention policies to sensitize adult supervisors and to regulate dangerous food products in the market.
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Affiliation(s)
- Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Alexander Hochdorn
- Department of Social and Work Psychology, University of Brasília, Brasília, Brazil
| | | | - Andrea Francavilla
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Romina Valentini
- Dietetics Unit, Department of Medicine, University of Padova, Padova, Italy
| | | | - Giselle Cuestas
- Hospital de Pediatría Juan P. Garrahan, Buenos Aires, Argentina
| | - Hugo Rodriguez
- Hospital de Pediatría Juan P. Garrahan, Buenos Aires, Argentina
| | - Achal Gulati
- Department of Otorhinolaryngology (E.N.T.), Maulana Azad Medical College, New Delhi, India
| | - A. B. Sebastian van As
- Trauma Unit, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
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Ocagli H, Azzolina D, Bressan S, Bottigliengo D, Settin E, Lorenzoni G, Gregori D, Da Dalt L. Epidemiology and Trends over Time of Foreign Body Injuries in the Pediatric Emergency Department. CHILDREN-BASEL 2021; 8:children8100938. [PMID: 34682203 PMCID: PMC8534431 DOI: 10.3390/children8100938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/14/2021] [Accepted: 10/16/2021] [Indexed: 01/22/2023]
Abstract
This paper presents the epidemiology of foreign body injuries in the Pediatric Emergency Department (PED) of Padova (Italy) along with its trends over an eleven-year period based on administrative data. Annual incidence rates (IRs) of PED presentations for foreign body (FB) injuries per 1000 person-years were calculated. Univariable and multivariable generalized linear (GLM) Poisson models were estimated to evaluate the relationship between FB injury incidence and year, triage priority, nationality, injury site, and FB type. During the study period, there were 217,900 presentations of pediatric residents in the province of Padova; of these, 3084 (1.5%) reported FB injuries involving the ears, nose, throat, gastrointestinal tract or eyes. The annual IR of FB injury episodes increased from 10.45 for 1000 residents in 2007 (95% CI, 9.24, 11.77) to 12.66 for 1000 residents in 2018 (95% CI, 11.35, 14.08). Nonfood items were the FBs that were most frequently reported. The intermediate urgent triage code was the most represented for FB injuries, with IRs ranging from 5.44 (95% CI: 4.59, 6.40) in 2008 to 8.56 in 2018 (95% CI: 7.50, 9.74). A total of 170 patients who presented for FB injuries were hospitalized (5.5%). The annual FB-related injury IR has increased over time, although most episodes are not life threatening. Educational and prevention programs on FB-related injuries should be promoted and dedicated to childcare providers.
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Affiliation(s)
- Honoria Ocagli
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, via Loredan 18, 35128 Padova, Italy; (H.O.); (D.A.); (D.B.); (E.S.); (G.L.); (D.G.)
| | - Danila Azzolina
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, via Loredan 18, 35128 Padova, Italy; (H.O.); (D.A.); (D.B.); (E.S.); (G.L.); (D.G.)
- Department of Medical Science, University of Ferrara, via Fossato Mortara 64 b, 44121 Ferrara, Italy
| | - Silvia Bressan
- Pediatric Emergency Unit—Department of Women’s and Children’s Health, University of Padova, via Nicolò Giustiniani, 3, 35128 Padova, Italy;
| | - Daniele Bottigliengo
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, via Loredan 18, 35128 Padova, Italy; (H.O.); (D.A.); (D.B.); (E.S.); (G.L.); (D.G.)
| | - Elisabetta Settin
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, via Loredan 18, 35128 Padova, Italy; (H.O.); (D.A.); (D.B.); (E.S.); (G.L.); (D.G.)
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, via Loredan 18, 35128 Padova, Italy; (H.O.); (D.A.); (D.B.); (E.S.); (G.L.); (D.G.)
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, via Loredan 18, 35128 Padova, Italy; (H.O.); (D.A.); (D.B.); (E.S.); (G.L.); (D.G.)
| | - Liviana Da Dalt
- Pediatric Emergency Unit—Department of Women’s and Children’s Health, University of Padova, via Nicolò Giustiniani, 3, 35128 Padova, Italy;
- Correspondence: ; Tel.: +39-049-8275384
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Hochdorn A, Oliveira A, Lorenzoni G, Francavilla A, Baldas S, Berchialla P, Oliveira A, Alves VP, Gregori D, Azzolina D. Monitoring Public Perception of Health Risks in Brazil and Italy: Cross-Cultural Research on the Risk Perception of Choking in Children. CHILDREN (BASEL, SWITZERLAND) 2021; 8:541. [PMID: 34202693 PMCID: PMC8307887 DOI: 10.3390/children8070541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/20/2021] [Accepted: 06/22/2021] [Indexed: 11/17/2022]
Abstract
One of the most relevant public health issues among pediatric injuries concerns foreign body (FB) aspiration. The risk perception of choking hazards (CH) and risk perception, in general, are complex multifactorial problems that play a significant role in defining protective behavior. Risk prevention policies should take this aspect into account. A lack of scientific knowledge of FB injury risk perception may be evidenced in Brazil and other newly developed countries. This study aims to characterize the differences and peculiarities in risk perception of CH between Italian and Brazilian populations. The risk perception among adults in Italy and Brazil between September and October 2017 was investigated in a survey. A Multiple Correspondence Analysis was carried out to identify the latent components characterizing the risk perception in Italian and Brazilian population samples. The most relevant dimension characterizing risk perception is the "Professional-educational status and the related perception of Risk" (13% of factorial inertia). The Italians identify batteries and magnets as the most dangerous choking risks (20% of responses). On the other hand, Brazilian people, mainly manual laborers (22%) with secondary or primary education (94%), perceive coins as the most dangerous items (30% of responses, p < 0.001). Socio-economic issues characterize the subjective risk perception of Italian and Brazilian survey respondents. In this framework, data-driven prevention strategies could be helpful to tailor intervention strategies to the cultural context to which they are addressed.
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Affiliation(s)
- Alexander Hochdorn
- Department of Social and Work Psychology, University of Brasília, Brasília 72220-275, Brazil;
| | - Alexia Oliveira
- School of Medicine and Healthcare Sciences, Catholic University of Brasília, Brasília 72220-275, Brazil; (A.O.); (A.O.); (V.P.A.)
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy; (G.L.); (A.F.); (D.A.)
| | - Andrea Francavilla
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy; (G.L.); (A.F.); (D.A.)
| | | | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Torino, 10124 Torino, Italy;
| | - Alessandra Oliveira
- School of Medicine and Healthcare Sciences, Catholic University of Brasília, Brasília 72220-275, Brazil; (A.O.); (A.O.); (V.P.A.)
| | - Vicente Paulo Alves
- School of Medicine and Healthcare Sciences, Catholic University of Brasília, Brasília 72220-275, Brazil; (A.O.); (A.O.); (V.P.A.)
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy; (G.L.); (A.F.); (D.A.)
| | - Danila Azzolina
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy; (G.L.); (A.F.); (D.A.)
- Department of Medical Science, University of Ferrara, 44121 Ferrara, Italy
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Lorenzoni G, Azzolina D, Baldas S, Messi G, Lanera C, French MA, Da Dalt L, Gregori D. Increasing awareness of food-choking and nutrition in children through education of caregivers: the CHOP community intervention trial study protocol. BMC Public Health 2019; 19:1156. [PMID: 31438901 PMCID: PMC6704497 DOI: 10.1186/s12889-019-7469-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 08/11/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Choking is one of the leading causes of death among unintentional injuries in young children. Food choking represents a considerable public health burden, which might be reduced through increased effective preventative education programs. We present a protocol for a community intervention trial termed CHOP (CHOking Prevention project) that aimed to teach Italian families how to prevent food choking injuries and increase knowledge relating to nutrition. METHODS Italian educational facilities were enrolled. Stratified randomization blocked by geographical area was performed. Each stratum was randomized to one of three different intervention strategies or to a control group. Educational intervention was delivered in the schools by experts and certified trainers as per the following three intervention strategies: directly to families (Strategy A); to teaching staff only, who subsequently delivered the same educational intervention to families (Strategy B); to health service staff only, who then delivered the educational intervention to teaching staff, who subsequently delivered the intervention to families (Strategy C). Participants completed a questionnaire about their knowledge on the topics presented during the educational interventions (pre-, post-, and follow-up of intervention). Information from the questionnaires was synthetized into 6 indicators in order to measure how effective each intervention strategy was. DISCUSSION The issue of food choking injuries in children is relevant to public health. The protocol we present provides an opportunity to progress towards overcoming such challenges through a working model that can be implemented also in other countries. TRIAL REGISTRATION ClinicalTrials.gov NCT03218618. The study was registered on 14 July 2017.
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Affiliation(s)
- Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan, 18, 35131, Padova, Italy
| | - Danila Azzolina
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan, 18, 35131, Padova, Italy.,Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | | | - Gianni Messi
- Department of Pediatrics, Burlo Garofolo Hospital, Trieste, Italy
| | - Corrado Lanera
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan, 18, 35131, Padova, Italy
| | | | - Liviana Da Dalt
- Division of Pediatric Emergency Medicine, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Via Loredan, 18, 35131, Padova, Italy.
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