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Foreign Body, Nasal, Emergency Medicine

Bradley E. Efune and David A. Pearson Reviewed 06/2017
 


Basics

Description

  • Object impacted in the nasal cavity

  • Most common site of foreign body insertion in children

  • Type of foreign body limited only by nostril size

  • Population at risk:

    • Children between 2–6 yr m...

Diagnosis

Signs and Symptoms

  • Most nasal foreign bodies are asymptomatic.

  • Unilateral nasal obstruction

  • Nasal pain

  • Difficulties with nasal breathing

  • Nasal discharge:

    • Acute or chronic

    • Unilateral

    • Foul smelling

    • Hal...

Treatment

Pre-Hospital

  • Cautions:

    • Transport in sitting position:

      • To avoid posterior displacement and possible aspiration of foreign body

  • Avoid interventions that upset the child.

    • Forceful negative inspirati...

Follow-Up

Disposition

Admission Criteria

Referral for ambulatory surgical removal: 
  • Foreign body cannot be recovered in ED

  • Removal under general anesthesia is required

Discharge Criteria

  • Ensure that there i...

Pearls and Pitfalls

  • Consider nasal foreign bodies in children 2–6 yr presenting with what appears to be sinusitis

  • Parents are best suited to perform positive-pressure removal to avoid frightening the c...

Additional Reading

  • Fundakowaski  CE, Moon  S, Torres  L. The snare technique: A novel atraumatic method for the removal of difficult nasal foreign bodies. J Emerg Med.  2013;44:104–106.

  • Heim  SW, ...

Codes

ICD9

932 Foreign body in nose 

ICD10

T17.1XXA Foreign body in nostril, initial encounter 

SNOMED

  • 74699008 foreign body in nose (disorder)

  • 33890007 Foreign body in nostril (disorder)

  • 66050007 Foreign bo...

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