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  Airway Obstructions Have High Death Rate for Young Children
April 19, 2010

--> Washington, DC – Though airway obstructions in young children occur less often than other types of injuries, the death rate is higher, according to new research from Children’s National Medical Center. The findings are published in the April issue of Archives of Otolaryngology-Head & Neck Surgery, an affiliate of the Journal of the American Medical Association.

The study, led by pediatric otolargyngologists Sukgi Choi, MD, and Rahul Shah, MD, found that airway obstructions in young children had a low incidence but a 3.4 percent mortality rate. The team compiled the information from a national database of children’s hospitalizations in 2003, which consisted of nearly 3,000 hospitalizations for airway obstructions.

“These findings are concerning and speak to the need for better education to prevent these airway obstructions from occurring,” said Dr. Choi. “Our hope is to prevent these injuries from occurring.”

Children’s National Medical Center offers the following tips to minimize choking hazards:

  • Supervise all meals and have children eat at the table or in a high chair.
  • Small foods, such as grapes and hot dogs, should be cut into very small pieces.
  • Avoid small toys, like balls or marbles.
  • Consider using a small-parts tester, or an empty toilet paper roll, to test the size of toys. Children under age 3 should not be given toys that fit completely into the cylinder.
“As parents, we must take steps to prevent these types of injuries from happening,” added Dr. Shah. “We must also work with our governing agencies to ensure appropriate regulations are in place.”

The study found that the average age of children hospitalized for airway obstructions was 3.5 years old, which 55 percent of the patients under 2. Foreign bodies were classified as food and non-food items, with food items causing 42 percent of the airway obstructions.

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Contact: Emily Dammeyer or Jennifer Leischer at 202-476-4500.

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Children’s National Medical Center, located in Washington, DC, is a leader in the development of innovative new treatments for childhood illness and injury. Children’s has been serving the nation’s children for more than 135 years. Children’s National is consistently ranked among the best pediatric hospitals by U.S.News & World Report and the Leapfrog Group. For more information, visit Children’s Research Institute, the academic arm of Children’s National Medical Center, encompasses the translational, clinical, and community research efforts of the institution. Learn more about Children’s Research Institute at

Preventing Choking

Experts from Children's National Medical Center and Safe Kids Worldwide offer the following tips to parents and caregivers to prevent choking and other airway obstructions.


  • Supervise your baby when he or she is eating and playing.
  • Avoid giving your baby small, hard, or round foods.
  • Cut foods into small pieces and give infants soft foods that they do not need to chew.
  • Learn CPR for infants.
  • Remove strings and cords from baby's clothing.
  • Actively supervise your baby when he or she is playing.
  • Do not let babies play with small, rounded, and oval objects (like balls and marbles), which can easily fit into a child’s mouth and throat.
  • Remove crib toys with strings, cords and ribbons, which can present a strangulation hazard.
Toddlers and Older Children
  • Keep un-inflated balloons and broken balloon pieces away from children.
  • Supervise young children while they are eating.
  • Make sure all meals are consumed at the table or in a high chair.
  • Cut foods into small pieces.
  • Do not allow children under age 3 to eat small, round or hard foods, including small pieces of hot dogs, hard candy, nuts, grapes and popcorn. Other hazardous food items include raw vegetables, jellybeans, raw unpeeled fruit slices, dried fruits, grapes or chunks of meat.
  • Do not let your child eat or suck on anything like candy while lying down or playing. Have children sit in a high chair or at a table while they eat.
  • Get on the floor on your hands and knees, so that you are at your child’s eye level. Look for and remove small items such as jewelry, coins, buttons, pins, nails and stones.
  • Children should play with safe and age-appropriate toys, as indicated by choking hazard safety labels. Toys that are labeled for children 3 years and older should be kept away from children under age 3. These toys may have small parts and could cause choking if placed in the mouth.
  • Regularly check toys for damage that may have created loose small parts. Damaged or dangerous toys should be repaired or thrown away immediately.
  • Use an empty toilet paper roll as a guide for what is an appropriate size. Any toy that fits in the cylinder is not appropriate for young children.
  • Sign up to receive product recalls with the Consumer Product Safety Commission at
For more safety tips, visit

What to do if your child is choking

All caregivers should receive proper training in infant and child CPR to know what to do in an emergency. Check with your local hospital or health department to sign up for a class.

If your child is choking, try to remove the object by performing a finger sweep. The next option is to perform the Heimlich to try to remove the obstruction.

If that doesn’t work, call 9-1-1 right away.