Dr. First’s Two Cents on Coin Swallowing

Parents have been nickel-and-diming me as to what to do when their child swallows a coin.  Let me see if I can cough up some information on this topic.

As children explore the world, usually between the ages of 6 months and 4 years, it is almost inevitable that they will swallow things that are not necessarily nutritious – and coins probably lead that list.  At least 30,000 children are seen annually for coin ingestions in emergency departments, not counting those who end up at doctor's offices.  The good news is that if the coin is the size of a quarter or smaller, it almost always passes onward and outward uneventfully within a few days.

On rare occasions, a coin can get stuck in the food pipe or air pipe and becomes a medical emergency.  You'll know this because your child will have difficulty breathing, talking, gasping, or may be changing color from red to blue in the face, and appear very panicked.  If this is the case, call 911 where you will likely be instructed on how to perform the Heimlich maneuver while help is on the way.  What is the Heimlich maneuver?  It is a maneuver that allows you to push air upward from just below the ribs through the windpipe to dislodge the coin or whatever else your child is choking on. 

If you are at all concerned about where the coin might be, and all parents are even if your child has no symptoms, please call your child's doctor who most times will want to get an x-ray to locate the coin and provide reassurance that things are moving in the right direction.  If it is caught in the food pipe, a gastrointestinal or surgical specialist will be called to help remove the coin with the use of a device called an endoscope.           

Of course the best way to prevent your child from swallowing a coin is to keep coins away from small children, such as in a piggy bank, and while you're at it, consider keeping small disk batteries away as well.  These need to be removed even if they have passed the food pipe and are parked in the stomach because they can cause serious injury due to the chemicals inside of them that can be released once swallowed.

Hopefully tips like this will change things for the better when it comes to making sure that when a coin is accidentally swallowed, everything will come out fine in the end.

Lewis First, M.D., is chief of Pediatrics at Vermont Children's Hospital at Fletcher Allen Health Care and chair of the Department of Pediatrics at the University of Vermont College of Medicine. You can also catch "First with Kids" weekly on WOKO 98.9FM and WPTZ Channel 5, or visit the First with Kids video archives at http://www.FletcherAllen.org/firstwithkids