When using a big ballpoint pen from childhood, you always remember that there is a small hole in the cap, but you don't know what the hole is for?
Recently, many media on the Internet have also released such news: there is a "life-saving hole" on the pen cap. When children accidentally inhale the pen cap, the small hole can ensure that the respiratory tract is not completely blocked, and strive for precious rescue time. Therefore, the air hole is also included in the compulsory production standard. The news has aroused wide discussion among netizens, and many people are skeptical of the idea of "saving lives". They think that the function of adding holes in the pen cap is just to balance the air pressure to prevent the cover from being opened. Is it really necessary to have a "life-saving hole" on the cap? How effective is it in preventing accidents?
Inhaled cap: a real risk
All over the world, foreign body inhalation does pose a great threat to children's life and health. According to the Centers for Disease Control and Prevention (CDC), in 2000 alone, 160 children (or adolescents) aged 14 or under died of foreign body inhalation related airway obstruction. CDC also pointed out that each case of asphyxia due to inhalation of foreign bodies means that more than 100 rescue cases have occurred at the same time. In 2001, an estimated 17537 children and adolescents aged 14 or under were rescued due to asphyxia.
School age children often have to deal with pens. Many children put pen caps in their mouths for the reasons of transferring pressure, concentrating thinking or simply feeling fun. These behaviors and habits constitute the potential risk of pen cap inhalation. In the above CDC statistics, 41% of the foreign bodies causing asphyxia death were food, and 59% were non food foreign bodies. It has also been reported that in the inhalation of non food foreign bodies, pen caps account for 3% ~ 8%. It can be seen that there is a real risk of suffocation in children. Among the daily items listed by the American Academy of Pediatrics (AAP) that may cause children's suffocation, the pen cap is also included (other items to be noted include coins, balloons, marbles, button batteries and small parts of toys).
Which caps should have holes?
According to the provisions of the national standard of the people's Republic of China General requirements for the safety of student supplies, the caps of writing pens, marker pens, correction pens and watercolor pens shall meet at least one of the following three provisions:
① the size of the pen cap is large enough (when entering the gauge with a diameter of 16mm vertically, the non passing part is larger than 5mm)
② a continuous air passage of at least 6.8 mm2 is required on the cap body. The air passage can be provided by a raised part such as a pen holder.
③ the pen cap shall have a minimum ventilation capacity of 8 L / min at a maximum pressure difference of 1.33 kPa at room temperature.
Qualified caps that meet this standard may not have holes, but they all need to be increased in size or ventilation to reduce the risk of inhalation asphyxiation.
Similar regulations are not unique to China. In fact, the safety technical indicators and test methods of pen caps in the aforementioned national standards are exactly the standards in ISO 11540:1993 "safety requirements for writing pens and markers". At this point, China is in line with the international standards.
By the way, though, the criteria here are for pens used by children 14 or younger. Jewelry pens, high-grade pens, or drawing pens used by professionals, which are usually only used by adults, are not covered by this standard.
How useful is the air passage?
Foreign body inhalation is a very dangerous thing. If the main airway is blocked, the following asphyxiation will quickly damage the body. As long as the hypoxia caused by asphyxia lasts for more than four minutes, it can cause irreversible brain damage or even death. At this time, first aid measures must be taken immediately.
In general, Heimlich's first aid method (see "extended reading" for details) or foreign body forceps under rigid tracheoscope are the magic weapons to rescue foreign body obstruction. However, when the pen cap enters the respiratory tract by mistake, the emergency treatment process may face more severe challenges. Pen caps have a number of particularly tricky properties: their size and shape are particularly 'fit' to the human respiratory tract, and their materials are often hard and inelastic, and the surface is very smooth. These characteristics make it possible for the cap to lock the respiratory tract tightly, making it difficult for the treatment measures to be carried out smoothly. Moreover, X-ray examination may not guarantee the timely discovery of plastic caps. Due to these factors, the actual time needed to remove the cap may be far beyond the optimal rescue time limit.
If there is enough air passage on the cap, the situation will be very different. Even if the cap cannot be removed quickly, the respiratory tract will not be completely blocked by it. This will at least save lives and earn enough time for treatment.
The importance of the air passage on the cap can also be illustrated by the following real case:
This is a child foreign body inhalation case from Miami Children's hospital. The main character of the case is a nine-year-old child who went to the hospital for treatment due to upper respiratory symptoms. The child had swallowed a plastic pen cap before, but the X-ray showed no abnormality. Since then, the child has continued to cough and asthma. Miami Children's hospital decided to perform bronchoscopic foreign body forceps. During the operation, doctors found that a plastic cylindrical foreign body completely blocked the respiratory tract - a pen cap. Fortunately, a hole was opened in the center of the pen cap. The air was circulated and oxygen was continuously supplied to the end of the bronchus, so that the poor child at least had no life worries. Even so, the treatment is still very difficult: the forceps can't hold the cap - the plastic surface is too smooth. In the end, the hospital had to use other programs to remove the cap. Imagine that if there is no air passage on the pen cap that the child inhales, it is absolutely impossible to win the time buffer of nearly 20 days.
Thus, it can be seen that the design of air passage on the pen cap plays an important role in the prevention of children's accidental asphyxia, which is also clearly stipulated in China and the international community. When choosing stationery, toys and other supplies for children, the risk of suffocation is also a factor worthy of serious consideration.