To the Editor:--As an anesthesiologist who specializes in the care of children, I am acutely aware of the choking potential inherent in common foods and toys. A recent modification to face masks manufactured by Vital Signs (Totowa, NJ) caused me great concern. A small plastic cap was added to the mask to cover the nipple used to inflate or deflate the cuff (Figure 1). This cap is easily removed, and is of a size (approximately 7 mm x 5 mm) and shape to be aspirated readily; if aspirated, the cap could completely block the airway and would be difficult to extract. We sometimes give these masks to children before surgery for medical play, or send the masks home as souvenirs after surgery. I am concerned that these caps pose a choking hazard to our pediatric patients.

Figure 1. Vital Signs toddler mask. Arrow points to cap.

Figure 1. Vital Signs toddler mask. Arrow points to cap.

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We contacted Vital Signs, and it is our understanding they plan to eliminate the cap from pediatric face masks. In the meantime, I urge anesthesiologists who care for children to remove the cap from Vital Signs masks before giving the masks to children as toys or souvenirs.

Joel B. Gunter, M.D.; Associate Professor; Clinical Anesthesia and Pediatrics; Children's Hospital Medical Center; 3333 Burnet Avenue; Cincinnati, Ohio 45229-3039

(Accepted for publication April 18, 1996.)