title: Airway foreign bodies: A critical review for a common pediatric emergency.
abstract: BACKGROUND
  Airway foreign bodies (AFBs) is an interdisciplinary area between emergency medicine, pediatrics and otolaryngology. It is a life-threatening condition that is not infrequently seen; however, it is poorly covered in medical literature. Accidental aspiration of an element into airways is a widespread clinical scenario among children under 3 years, predominantly males. Moreover, it is the leading cause of infantile deaths and the fourth one among preschool children.
  
  
  METHODS
  A systemic search was conducted in July 2015 using PubMed/PubMed Central Database of The National Center for Biotechnology Information (NCBI) (http://www.ncbi.nlm.nih.gov/). A total of 1 767 articles were identified and most of them were meta-analyses, systematic reviews, and case series. Those thoroughly discussing assessment and management of AFBs were retrieved.
  
  
  RESULTS
  AFBs episodes may be either witnessed or missed. Presence of a witness for the inhalation is diagnostic. The later usually present with persistent active cough. A classical triad of paroxysmal cough, wheezing, and dyspnoea/decreased air entry was reported, though many presentations have inconsistent findings. Hence, diagnosis requires high index of clinical suspicion. Flexible fibro-optic bronchoscopy is the gold standard of diagnosis, whereas inhaled objects are best retrieved by rigid bronchoscopes.
  
  
  CONCLUSIONS
  Close supervision of pediatrics is the hallmark of prevention. Caregivers should ensure a safe surrounding milieu, including the toys their offspring play with. Immediate complications result from direct obstruction or injury by the inhaled object. Alternatively, prolonged lodging traps air and induces inflammatory response causing atelectesis and pneumonia, respectively.
authors.affiliation: Faculty of Medicine, International University of Africa, Khartoum, Sudan; College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, EH8 9YL, UK.
authors.forename: Alaaddin M
authors.initials: AM
authors.lastname: Salih
authors.affiliation: Ribat University and Central Police Hospitals, National Ribat University, Khartoum, Sudan.
authors.forename: Musab
authors.initials: M
authors.lastname: Alfaki
authors.affiliation: Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
authors.forename: Dafalla M
authors.initials: DM
authors.lastname: Alam-Elhuda
keywords: Airway foreign bodies; Airway obstruction; Aspiration/inhalation; Breathing difficulties; Café coronary syndrome