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It seems kids will never stop coming up with creative ways to injure themselves, if the cases of three teen boys and their homemade blowguns are any indication.
Doctors at one hospital describe treating the boys who each accidentally swallowed a dart from blowguns they'd constructed themselves -- with help from the Internet -- in the August issue of the journal Pediatrics.
The first case was a 15-year-old who landed in the emergency department after having a three-hour coughing spell. X-rays revealed a foreign object in his airways, and the boy admitted that he'd accidentally inhaled a dart from his do-it-yourself blowgun.
Over the next three months, two other teen boys arrived in the ER with the same injury.
People usually think of preschoolers as being the age group at risk of accidentally swallowing a foreign object, noted Dr. Kris Jatana, one of the authors of the report. But, he said, doctors should also have this possibility on their radar when an older kid arrives in the ER with an unexplained cough or wheezing.
"With this age group, it's sometimes hard to get an accurate history," said Jatana, an ear, nose and throat surgeon at Nationwide Children's Hospital in Columbus, Ohio.
That is, teenagers are not all that forthcoming when they've done something they shouldn't have -- in this case, construct a homemade blowgun. All three boys found instructions online.
"The Internet is an avenue for this information to get out there to kids," Jatana said. He and his colleagues found 20 websites that offer a homemade blowgun "how-to" guide. Some of the sites, Jatana said, warned people not to point the gun at others, but none brought up the risk of inhaling -- or aspirating -- a dart.
"It's a real setup for aspiration," Jatana said. To use the gun, he explained, you have to take a deep inhale before sending a forceful exhale into the device, which then propels the dart. But if a child mistakenly puts his mouth on the device while he inhales, the dart can easily be sucked into the airways.
Luckily for the three boys in this report, the doctors were able to easily remove the dart with a bronchoscope -- a thin, flexible tube that's passed through the throat to the airways.
"Fortunately, these kids were fine," Jatana said. But, he added, any time a foreign object gets lodged in the airways, it's a potentially fatal situation.
An ER doctor not involved in the study agreed that suspicions should be raised if a teen has first-time wheezing and there's no clear potential cause -- such as a cold or exposure to noxious fumes.
"An X-ray may be warranted in these cases," said Dr. Michael Lanigan of SUNY Downstate Medical Center, in New York City.
In training, Lanigan noted, doctors are taught to X-ray younger children with first-time wheezing, to see whether there's a foreign object in the airways. "I never thought I'd say the same for adolescents or adults," he added.
Lanigan agreed that these three boys were fortunate. "Aspiration or swallowing of any sharp object is always particularly dangerous," he said. A sharp object can not only obstruct, but also puncture, the airways or intestines. A perforation in those passages could lead to "spillage" of bacteria and "potentially catastrophic results," Lanigan said.
The simple truth, according to Lanigan, is that playing with homemade blowguns is a "really bad idea."
The American Academy of Pediatrics has advice on handling a choking emergency.