title: Foreign body removal in children: Recommendations versus real life-A survey of current clinical management in Germany.
abstract: Task forces of the European Respiratory Society (ERS, 2003) and the American Thoracic Society (ATS, 2015) both recommend rigid bronchoscopy for foreign body removal in children. However, there is an increasing number of publications recommending flexible bronchoscopy as primary method for foreign body removal in children.
  
  
  
  We therefore initiated a nationwide survey, investigating the routinely used method of foreign body removal in children in different centers in Germany.
  
  
  
  In total, 259 centers took part in the survey. Twenty percent used flexible bronchoscopy as primary method of choice for foreign body removal. Of note, only 40% of the respondents reported that they had attended formal training courses in flexible bronchoscopy, 15% in rigid bronchoscopy, and 42% had never attended a formal training. Twenty-five percent indicated that they had already encountered an emergency situation during or after foreign body removal, requiring intensive care.
  
  
  
  Published data shows that rigid bronchoscopy involves fewer complications and is more successful in foreign body removal in children. It is consequently questionable, why 20% of the medical centers report a preference for the flexible method. One reason might be the poor availability of rigid bronchoscopy and the difficulty gaining sufficient expertise in rigid bronchoscopy in Germany. Pediatr Pulmonol. 2017;52:656-661. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of General Pediatrics, Neonatology and Pediatric Cardiology, Heinrich-Heine University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Schramm
authors.affiliation: Department of General Pediatrics, Neonatology and Pediatric Cardiology, Heinrich-Heine University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Ling
authors.affiliation: Department of General Pediatrics, Neonatology and Pediatric Cardiology, Heinrich-Heine University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
authors.forename: Antje
authors.initials: A
authors.lastname: Schuster
authors.affiliation: Department of Pediatrics, Ludwig-Maximilians-University of Munich, Munich, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Nicolai
mesh_terms: D001980:Bronchi / Q000601:surgery*; D001999:Bronchoscopy / Q000379:methods*; D002648:Child; D003422:Critical Care; D005260:Female; D005547:Foreign Bodies / Q000601:surgery*; D005858:Germany; D019538:Health Care Surveys; D006282:Health Personnel; D006801:Humans; D008297:Male
keywords: flexible bronchoscopy; foreign body aspiration; foreign body removal; rigid bronchoscopy