Accidents, Emergencies and a Swallowed Coin

Two evenings ago, Hercules swallowed a coin. In spite of all our best intentions to make sure there are no hazards for our children around the house, the older they grow, the more resourceful they become, and the harder it is to keep the house “safe”. Of course, having a child like Hercules also increases the risk of these incidences happening. As is it, this was not his first visit to the hospital but the third – the first was when he cut his brow and the second was when he had dengue. You would never expect something like this with Aristotle because he never put foreign objects into his mouth and he never did anything “dangerous”.

What happened?

Hercules was tired and hungry so I served him dinner early. He ate a large bowl of Niku Udon. When he finished, he said he was still hungry, so I gave him a bowl of strawberries for dessert. He was done by 6pm. Aristotle hadn’t eaten so I sat Hercules in front of the TV for an episode or Tom and Jerry, thinking to put him straight to bed after I served Aristotle his dinner.

Just as I was coming out of the kitchen, I heard Hercules coughing. It sounded like he was choking on something. I rushed to him and brought him to the sink and tried to help him get whatever it was out. I asked him what he put in his mouth (since he was long done with any food) and he finally answered, “A coin.”

I write this all very calmly now that Hercules is safe and well, but I assured you, I was anything but calm that night. I should also add that we do not leave coins lying around and there were definitely no coins around the living area. I only discovered later (upon questioning Hercules after we got back from the hospital and all was well again) that he climbed a stool to access a drawer where Daddy kept his spare change. Just when we thought it should be getting easier, we are reminded that the older kids are more resourceful – it’s much harder to keep them from danger because they go in search for it.

I tried to get Hercules to throw up the coin but all that came out where the noodles from dinner and the strawberries. After a while, Hercules calmed down and it seemed like everything was back to normal. I thought perhaps the coin had made it down to his stomach. I called the hospital and my brother (non-practicing medical doctor – long story that one) for advice. We ended up heading to the hospital to A&E (accidents and emergency) for a chest x-ray even though we thought it made it to the stomach. It turns out it was just as well we checked because this was where the coin really was:

Since it was fairly high up, the ENT was called to come in and get it out. According to the ENT, it was mostly likely a 20 sen coin (roughly the size of an Aussie 10 cent) because he has never had to pull out anything smaller as they usually make it to the stomach. He didn’t think it was a 50 either because those are usually too large for a child of Hercules’ age to swallow. In fact, just from the way he talked about it, swallowed coins seemed to be a common occurrence. It was really no different to a swallowed fish bone, except that it was usually easier to remove without complications.

He did a laryngoscopy which he says usually takes about 2 minutes. Because Hercules is a child and children struggle, he had to go under a GA. So the big commotion was really getting him prepped and putting him under. By the time the procedure was over, it was pretty late, so Hercules has to stay overnight for monitoring and recovery.

The doctor said that there was a slight cut on his throat which meant that he might have trouble eating or drinking. If we were concerned, we should not have been. Once Hercules knew that the coin was out, he wasted no time tucking into his breakfast. Lunch was a big bowl of noodles and dinner was a healthy serve of Bah Ku Teh. His return home was so uneventful it was as if the whole incident had never happened. The only thing that tells us it really did happen was the X-ray, the hospital bill, and this souvenir:

I realised that I was actually quite unprepared for an accident like this. No matter how “safe” you keep your house, it is always best to know what to do in the event of an emergency. So I looked up some pointers for a refresher on choking…

What do you do if something goes down your child’s throat?

1. Assess the danger

• can your child breathe?
• is your child in distress?
• is your child coughing, wheezing, crying?
• is your child silent and turning red or blue?
• do you know what your child swallowed? Some items can cause damage – batteries, pins, etc.

2. Help your child dislodge the object

• your child needs to be in a position with his head lower than his body
• thump your child’s back
• in an older child, encourage the coughing as it can help to dislodget the object; don’t put your fingers down the back of his throat, you might push the object further in
• See: Infant First Aid for Choking for babies

3. Take your child to the A&E department of the hospital

Some sites say it’s okay to adopt a watch and wait if your child is not in distress and see if it comes out in his poop. I say bugger that, just go to the hospital and get the chest x-ray to see where it is. And if you don’t know what the object is, you need to find out if it’s dangerous to leave it there. If it’s in the stomach and the object is relatively harmless, then you’ll just need to wait until it comes out in the poop within the next couple of days. Of course, if it doesn’t, then you’ll need to go back to the doctor’s to have it removed because it is obviously having trouble being eliminated.

The real danger of swallowing an object is if it is not in the stomach. You need to know whether it’s stuck somewhere along the way down or if it entered the lungs. In either case, it needs to be removed because it can cause an infection and serves as a blockage.

The reason why I say just go to the hospital even if your child doesn’t appear to be in distress is because some children might be like Hercules – they don’t appear to be in distress even though the coin is stuck. Based on Hercules’ reaction, we all thought it was already in the stomach. The X-ray was merely a formality to confirm that fact. Lucky we checked…

Related:

• Baby Center – Swallowed object or object stuck in wind pipe
• Livestrong – What happens if my child swallows a coin
• AAFP – What to do if your child swallows something
• Parents – I can’t believe my kid swallowed that!