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Thursday, 6 July 2017

Nasal Foreign Body

Nasal foreign bodies are surprisingly common. The technique is not too dissimilar to that of removing auricular foreign bodies. In theory, they might be hidden behind a turbinate and tricky to see - and therefore tricky to remove.

1. Mother's Kiss
This works in 60% of cases. Occlude patent nostril. Get Mum to blow into the mouth. You can do this with a BVM if needed - but be careful the pressure isn't too high.

2. Suction
Like with FBs in the ear, gentle suction, can help. I guess glue could too - although I haven't seen any case reports of this.

3. Curved Needles
If you can't find one, as we can never find them in the ED, bend a green needle, and that should help!

4. Foley Catheter
Inflate baloon with 0.5 - 3ml water or air. Insert it behind the foreign body, and then pull. I've never tried this, but it seems to be really frequently used outside the UK!

 References
http://journals.lww.com/em-news/blog/M2E/Pages/post.aspx?PostID=17
http://www.emdocs.net/ear-nose-throat-foreign-bodies/ 
https://wikem.org/wiki/Nasal_foreign_body 
http://pmj.bmj.com/content/76/898/484
http://epmonthly.com/article/how-to-remove-a-nasal-foreign-body-with-a-balloon-catheter/
https://lifeinthefastlane.com/nasal-foreign-bodies/
http://www.racgp.org.au/download/Documents/AFP/2013/May/201305handi.pdf 
http://emedicine.medscape.com/article/763767-overview?pa=kFsFTvrB8j%2FPtwK%2BOEAs61ub09VNBtvaAN6mPVwMp%2FDFndF9mwj4ym0rESwqOfDUa5AxknqcRm1Zi18mAza%2B0XnZ5j5IICuJuaa3Z%2BY2XGY%3D#a4
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