A heartbreaking incident happened in Tiruttani of Tiruvallur district of Tamil Nadu, where a four-year-old child died of suffocation after a tablet given for fever got stuck in the throat. After a child of R Pallikuppam village near Tiruttani got fever, the family members took him to the Tiruttani Government Hospital on the morning of 18 August. There the doctor prescribed some medicines for the child. The child’s parents say that they gave medicine to their son the same night.
But while swallowing the tablet, it got stuck in the throat and the child started having difficulty in breathing. The family immediately took him to Tiruttani Government Hospital, where the doctor declared the child dead. What things should be kept in mind while giving medicine tablets to children? Can adults also face such danger while taking medicine tablets or capsules?
According to the American Academy of Pediatrics, “Children under the age of five can suffocate if food or any small object gets stuck in their throat. If something gets stuck in the windpipe and the airway gets blocked, then oxygen can stop reaching their lungs and brain.” “If the brain does not get oxygen for more than four minutes, then it can cause damage to the brain and even death.”
While according to Harvard Medical School, “Swallowing a pill is not that easy. It is a challenge not only for small children but also for some adults. One out of every three people who try to swallow a pill has problems like vomiting or difficulty in breathing.” On this subject, Erode’s pediatrician Arun Kumar said, “Generally it is not right to give tablets to children below 6 years of age. They should be given a medicine by grinding it and mixing it in water. Water soluble medicines are mostly recommended for children.”
According to Dr Arun Kumar, usually the best way is to swallow the tablet with some water in the mouth, but it is difficult for small children to do this, so it is better to grind the tablet into a powder and mix it with water. He said that some medicines are available only in tablet form and their syrup is not available, so sometimes it is common to prescribe tablets for children.
He says, “It is the doctor’s job to tell how to give medicine to children, but it is the responsibility of the parents to take utmost care while giving tablets to children.” The World Health Organization also advises to grind the medicines and mix them with water to prevent the risk of suffocation and death in children.
Harvard Medical School has stated in an article, “It can be difficult for the elderly to swallow pills, especially for people over 65 years of age. As they grow older, they have to take more medicines, so there is a possibility of the pill getting stuck in their throat and causing difficulty in breathing.”
This article also states that due to reasons like nausea, vomiting and difficulty in breathing, the elderly often shy away from taking medicines, which can further deteriorate their health. According to the article, the size, shape and taste of the pill also makes it difficult to swallow. In America, about 20 million people take the diabetes medicine metformin, the large size of whose tablet is considered a serious problem.
Dr. Arun Kumar said, “One should be careful while giving tablets to the elderly. It is better to dissolve the medicine in water and give it. This will eliminate the need to swallow the tablet. If the medicine is in capsule form, it can also be broken and mixed in water and given.”
Dr. Arun Kumar said, “If any object gets stuck in the throat of children or adults and they start having difficulty in breathing, then a first aid called ‘Heimlic Maneuver’ should be done immediately.” He told, “For this, stand behind the patient and tie both hands tightly around his waist. Then apply strong pressure upwards from the stomach area 5–6 times. If the object stuck in the throat does not come out even with this method, then the person should be taken to the doctor immediately.”
In the 1960s, a large number of people were dying in America due to any food, toy or other object getting stuck in the throat. The ‘Heimlich Maneuver’ was adopted there in the year 1974. However, Arun Kumar said that this method should not be used on children below one year of age, unconscious patients and pregnant women.
Dr. Kumar advises that if the child is less than one year old, then he should be taken in the lap and patted on his back. He further said, “This first aid is being taught in many schools. Everyone should be taught this, because it is a very easy method.”
Dr. Revathi, Senior Consultant of the Department of Pediatrics in a private hospital in Chennai, says, “Whether you give the medicine by grinding it or directly in the form of a tablet, children should never be forced to take it. By doing this they can get scared and nervous, which increases the risk of breathing problems.”
She advised that children should be gradually made to get used to taking tablets by explaining and teaching them. Dr. Revathi said, “Some people dissolve the tablet in water and put it in the mouth of the child by closing the nose, this is completely wrong and very dangerous method.”
She said that the breathing tubes of small children are narrow, so there is a greater risk of the tablet getting stuck in the throat, children below six years of age should always be given tablets by dissolving them in water. She advises, “For children aged 6 to 10 years, it is better to give the medicine by breaking it into pieces or chewable tablets. Children above 10 years of age can be asked to swallow the tablet, but caution should be taken in that too.”
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