Kid Chokings Still 'Extremely Serious' Problem

(April 19) -- Millions of young children continue to be injured from choking-related accidents, and death rates are "surprisingly high," according to a new report.

"The aspiration and ingestion of foreign bodies presents a potential lethal threat to infants and children," states the report, published this week in the Archives of Otolaryngology -- Head & Neck Surgery.

Researchers at the Children's National Medical Center and the George Washington University School of Medicine in Washington reviewed information from a national database of children's hospitalizations in 2003.

In a single year, 2.7 million pediatric patients, with an average age of 3.5, were admitted with airway obstructions because of a foreign body. Forty-two percent of the choking culprits were food items, with the rest classified as "inorganic" products, mostly toys.

The hospital visits that ensued were often lengthy and expensive. Kids were admitted for an average of 6.4 days, costing an average of $34,652.

Around 2,000 children, or 3.4 percent of all those admitted, died from the obstruction. To Dr. Rahul Shah, a pediatric otolaryngologist at the Children's National Medical Center, and the study's co-author, that's unacceptable.

"The death rate, to me, is unbelievable," he told AOL News. "It just shows that choking is absolutely not a benign health issue, but an extremely serious one."

The study doesn't indicate which foods were most often responsible for choking emergencies, but Shah said that parents should be wary no matter what's on the table.

"If every time parents fed their child, they kept in mind what could go wrong, I think we'd be a lot better off," he said. "We've simply become too complacent about this."

And the data does lend some credence to a recent appeal from the American Academy of Pediatrics that suggested designing a more "kid friendly" hot dog and instituting tougher regulations for labeling foods that could pose a hazard to children.

According to AAP research, hot dogs are to blame for around 17 percent of food-related asphyxiations among children. Seeds, nuts, grapes and raw carrots also often pose a threat.

"If you were to find the best engineers in the world and ask them to design the perfect plug for a child's airway, you couldn't do much better than the hot dog," Dr. Gary Smith, lead author of the AAP policy statement, told AOL News in February. "It is the right shape and the right size to wedge itself in and completely block a child's airway. It's only a matter of minutes before permanent brain damage and death occur."

In addition to potential food redesigns, the AAP wants to see warning labels on risky foods, much like those that already appear on packaging for children's toys.

But the federal government's Consumer Product Safety Commission, which is responsible for such labels, might also need to rethink its standards.

The study found an increase in the number of hospital admissions for non-food-related items, especially among children older than 3, which is the cut-off age for many toy packaging warnings.

And while the federal government enforces strict regulations with regard to pacifiers and rattles, the study's authors caution that "many small objects still pass inspection and present a lethal threat to infants."

"Toys are affecting older kids, and that's really weird to me," Shah said. "Toy manufacturers need to wear their 'parent hat' more often than their 'business hat' when they're considering how to design these products."

Redesigning the hot dog, however, probably wouldn't solve the problem.

"You redesign that and then what? French fries, hot dog buns, too?" he said. "That's a slippery slope."

No matter the regulations and redesigns, however, at least some instances of choking among young children will likely remain inevitable. For Shah, it's a question of minimizing the number of kids who end up in the hospital.

He wants to see parents practicing "prevention, prevention, prevention," and thinks more surgical simulations could better prepare new physicians.

"Virtual surgeries can help," he said. "The last thing you want is for a resident's actual hands-on training to take place on a child in critical condition."