Tele-triage for pediatric foreign body aspiration: A case report from rural India and its implications

Abstract

Background

Foreign body aspiration (FBA) is a potentially fatal pediatric emergency, particularly in children under three years of age. Diagnostic delays are common in rural and resource-limited settings due to limited access to specialists, leading to increased morbidity. Telemedicine can play a critical role in early recognition and timely referral.

Case Presentation

We report a 1.5-year-old boy from rural Haryana who developed a cough following almond ingestion. A teleconsultation was initiated via the eSanjeevani platform. On remote assessment, reduced air entry and wheeze on the left side raised suspicion of an airway foreign body. Chest X-ray revealed left lung hyperinflation with mediastinal shift. The child was urgently referred to a tertiary centre, where rigid bronchoscopy confirmed and successfully removed an almond from the left main bronchus. He recovered fully, with subsequent follow-up conducted via teleconsultation.

Discussion

This case highlights the value of telemedicine in early triage of pediatric FBA, especially in rural areas where bronchoscopy facilities are not immediately available. Prompt remote assessment facilitated timely diagnosis, urgent referral, and safe intervention, thereby preventing complications.

Conclusion

Tele-triage through national platforms like eSanjeevani is a viable and effective strategy to bridge critical gaps in pediatric emergency care and improve outcomes in rural and resource-limited settings.