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(b) Removed rubber fragment measuring 5<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>mm (L<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>H).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A boy aged 9 months was brought in after unintentional ingestion of rubber from a children’s playground (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) associated with an episode of choking with cough, respiratory distress and facial cyanosis lasting a few seconds. The salient symptoms thereafter had been intermittent stridor and cough.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The vital signs were good, with no respiratory distress, but the expiratory stridor persisted, especially when the child was agitated, with diffuse wheezing predominantly originating from the right upper lobe.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The findings of the chest radiograph (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) were compatible with the presence of a foreign body. The patient underwent an urgent flexible bronchoscopy (Broncho Fiberscope FB-8<span class="elsevierStyleHsp" style=""></span>V, 2.7<span class="elsevierStyleHsp" style=""></span>mm; Pentax, Japan) that confirmed the presence of the foreign body in the right bronchus (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>a). The foreign body was removed with a stone extraction basket (NGage Nitinol Stone Extractor, 2.2 Fr; Cook Medical, Ireland), typically used for removal of urinary stones (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>b). Although rigid bronchoscopy is the first choice for removal of an aspirated foreign body, flexible bronchoscopy can be an effective alternative in centres with experience in its use.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Eighty percent of paediatric episodes of foreign body aspiration occur in children aged less than 3 years,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and this is an important cause of accidental death in infants under 1<span class="elsevierStyleHsp" style=""></span>year.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Therefore, we must stress the need to implement preventive measures such as reconsidering the appropriateness of using rubber flooring on playgrounds in the context of current European standards.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Despite its advantages, such as its cushioning effect and slip-resistant properties, its safety is questionable because its structural integrity cannot be guaranteed. It is easily torn by children, especially if maintenance is deficient, producing small-sized particles that can cause severe episodes of bronchial aspiration.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-07-28" "fechaAceptado" => "2020-08-26" "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1121 "Ancho" => 1343 "Tamanyo" => 141017 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0140" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Rubber flooring in a typical playground.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 968 "Ancho" => 1337 "Tamanyo" => 73020 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0145" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Chest radiograph. Radiopaque feature in the right perihilar area, with no signs of air trapping.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 797 "Ancho" => 1501 "Tamanyo" => 124475 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0150" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(a) Flexible bronchoscopy: foreign body (arrow) in the right bronchus (carina, asterisk). (b) Removed rubber fragment measuring 5<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>mm (L<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>H).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Ruiz FE. Airway foreign bodies in children. Uptodate. Available from: <a target="_blank" href="https://www.uptodate.com/contents/airway-foreign-bodies-in-children">https://www.uptodate.com/contents/airway-foreign-bodies-in-children</a> (accessed en Junio 2020)." ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Foreign body aspiration in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Cohen" 1 => "S. Goldberg" 2 => "C. Springer" 3 => "A. Avital" 4 => "E. Picard" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Harefuah." "fecha" => "2015" "volumen" => "154" "numero" => "3" "paginaInicial" => "175" "paginaFinal" => "177" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25962247" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Norma Europea UNE-EN 1176: Equipamiento de las áreas de juego y superficies. Parte 1: Requisitos generales de seguridad y métodos de ensayo. 2009." ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000010000000004/v1_202404250845/S2341287924000838/v1_202404250845/en/main.assets" "Apartado" => array:4 [ "identificador" => "77701" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Paediatrics" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000010000000004/v1_202404250845/S2341287924000838/v1_202404250845/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287924000838?idApp=UINPBA00005H" ]
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