When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Foreign body aspiration

Last reviewed: 1 Apr 2025
Last updated: 10 Jan 2025

Summary

Definition

History and exam

Key diagnostic factors

  • choking crisis
  • unilateral decreased breath sounds
  • unilateral wheezing
Full details

Other diagnostic factors

  • intractable cough
  • fever
  • dyspnea
  • bilateral wheezing
Full details

Risk factors

  • decreased level of consciousness (Glasgow coma score <9)
  • age <4 years
  • age >70 years
  • bulbar dysfunction
  • male sex
  • cerebrovascular disease
  • dementia
Full details

Diagnostic tests

1st tests to order

  • chest x-ray
Full details

Tests to consider

  • CT chest
  • bronchoscopy
Full details

Emerging tests

  • ultrasound lung

Treatment algorithm

ACUTE

conscious

unconscious

Contributors

Authors

Arjun B. Chatterjee, MD, MS, FACP, FCCP, FAASM
Arjun B. Chatterjee

Professor of Medicine

Section on Pulmonary, Critical Care, Allergy, and Immunologic Disease

Wake Forest University School of Medicine

Winston-Salem

NC

Disclosures

ABC declares that he has no competing interests.

Acknowledgements

Dr Arjun B. Chatterjee would like to gratefully acknowledge Dr Septimiu Murgu and Dr Henri Colt, the previous contributors to this topic. SM and HC declare that they have no competing interests.

Peer reviewers

Amber Young, BSc, MB ChB, FRCA

Consultant Paediatric Anaesthetist

Department of Anaesthesia

Frenchay Hospital

Bristol

UK

Disclosures

AY declares that she has no competing interests.

Momen M. Wahidi, MD, MBA

Professor of Medicine

Pulmonary and Critical Care

Feinberg School of Medicine

Northwestern University

Chicago

IL

Disclosures

MMW declares that he has no competing interests.

Pyng Lee, MD

Senior Consultant

Department of Respiratory and Critical Care Medicine

Singapore General Hospital

Singapore

Disclosures

PL declares that he has no competing interests.

​Prashant Mahajan, MD, MPH, MBA

Professor of Emergency Medicine and Pediatrics

Vice-Chair

Department of Emergency Medicine

Chief

Pediatric Emergency Medicine

C S Mott Children's Hospital and University of Michigan Medical School

Ann Arbor

MI

Disclosures

PM declares that he has no competing interests.

Karima Lelak, MD

Clinical Assistant Professor

Department of Emergency Medicine and the Department of Pediatrics

C.S. Mott Children's Hospital

University of Michigan

Ann Arbor

MI

Disclosures

KL declares that she has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Boyd M, Chatterjee A, Chiles C, et al. Tracheobronchial foreign body aspiration in adults. South Med J. 2009 Feb;102(2):171-4. Abstract

Faro A, Wood RE, Schechter MS, et al. Official American Thoracic Society technical standards: flexible airway endoscopy in children. Am J Respir Crit Care Med. 2015 May 1;191(9):1066-80.Full text  Abstract

Hewlett JC, Rickman OB, Lentz RJ, et al. Foreign body aspiration in adult airways: therapeutic approach. J Thorac Dis. 2017 Sep;9(9):3398-409.Full text  Abstract

Perkins GD, Graesner JT, Semeraro F, et al. European Resuscitation Council Guidelines 2021: executive summary. Resuscitation. 2021 Apr;161:1-60. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Foreign body aspiration images
  • Differentials

    • Asthma exacerbation
    • Cystic fibrosis with exacerbation
    • Acute COPD exacerbation
    More Differentials
  • Guidelines

    • 2024 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations
    • European Resuscitation Council guidelines 2021: Executive summary
    More Guidelines
  • Patient information

    Pneumonia

    Bronchoscopy

    More Patient information
  • Videos

    Stridor

    Expiratory wheeze

    More videos
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer