The Internet, Adolescent Males, and Homemade Blowgun Darts: A Recipe for Foreign Body Aspiration abstract

We describe our experience with blowgun dart aspiration via an illustrative case series and review the resources available to teach children how to construct these objects. A 15-year-old boy presented with cough, wheeze, and eventually admitted to aspiration of a homemade blowgun dart. This instance heightened the awareness of our experience with blowgun dart aspiration as 3 cases presented within a 3-month period. Patients uniformly presented with cough and reported aspiration, and wheezing was noted in 2 of the 3. Although all ultimately admitted their behavior, 2 were initially reluctant to admit aspirating the blowgun dart. Radiographic findings of a needle-shaped metallic airway foreign body were consistent in all patients. Each admitted to finding instructions for blowgun dart construction on the Internet. Emergent rigid bronchoscopy with blowgun dart removal resulted in symptom resolution in all without complication. This represents the largest series of blowgun dart aspiration to date. During deep inhalation, when preparing to propel a blowgun dart, the vocal folds maximally abduct, leading to increased risk for aspiration. Twenty websites were identified providing instructions for the construction of homemade blowgun darts. With the accessibility of the Internet and number of instructional websites, this clinical entity may become more common in the future. Unfortunately, only a few of the websites provide any safety warnings. Certainly, prompt treatment can result in good outcomes; however, serious potential complications, including death, could occur especially given the hesitance our patients showed in divulging the truth of the inciting event. Pediatrics 2013;132:e519–e521 AUTHORS: Patrick C. Walz, MD,ab Melissa A. Scholes, MD,bc Meredith N. Merz, MD,ab Charles A. Elmaraghy, MD,ab and Kris R. Jatana, MDab aDepartment of Otolaryngology-Head and Neck Surgery, The Wexner Medical Center at Ohio State University, Columbus, Ohio; bDepartment of Pediatric Otolaryngology-Head and Neck Surgery, Nationwide Children’s Hospital, Columbus, Ohio; and cDepartment of Otolaryngology-Head and Neck Surgery, Children’s Hospital Colorado, Denver, Colorado