In paediatric practice feeding, eating, drinking and swallowing difficulties are present in up to 1% of children. Dysphagia is any disruption to the swallow sequence that results in compromise to the safety, efficiency or adequacy of nutritional intake. Swallowing difficulties may lead to pharyngeal aspiration, respiratory compromise or poor nutritional intake. It causes sensory and motor dysfunction impacting on a child’s ability to experience normal feeding. Incoordination can result in oral pharyngeal aspiration where fluid or food is misdirected and enters the airway, or choking where food physically blocks the airway The incidence is much higher in some clinical populations, including children with neuromuscular disease, traumatic brain injury and airway malformations. The prevalence of dysphagia and aspiration-related disease is increasing secondary to the better survival of children with highly complex medical and surgical needs. This article aims to outline the indications for performing videofluoroscopy swallow (VFS). This includes the technical aspects of the study, how to interrupt a VFS report and some of the limitations to the study.

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SummaryOne hundred and seventeen patients admitted to an intensive care unit were studied. to determine whether there is any relationship between laboratory data taken on admission to the unit and thejinal outcome (survival or non-survival)

Foreign body aspiration is a potentially fatal occurrence, particularly in children less than 3 years of age. Predisposing factors include the tendency to put objects into the mouth, poor chewing ability, lack of posterior dentition and uninhibited inspirations when laughing or crying. Classically, the history opens with a witnessed choking episode which would raise a high level of suspicion in the clinician. Ideally, this would lead to an investigative cascade resultant in prompt diagnosis and removal of the object without significant sequelae. The clinical presentation, however, of an unwitnessed foreign body aspiration can be non-specific and subtle from acute shortness of breath and difficulty breathing to intractable cough, fever and chronic wheeze. It can masquerade as a reactive airway or primary infective pathology and delay crucial diagnosis. A high index of suspicion is therefore required when assessing a child with any of these complaints. Commonly aspirated substances include food particles, hardware and toys. Retained foreign bodies can lead to severe and dangerous long-term consequences including atelectasis, pneumothorax, pneumomediastinum or even death. The purpose of this case is to demonstrate the diagnostic dilemma when dealing with young children and the understated presentation of an unwitnessed aspiration of a foreign body.