Welcome

I struggled to find PEM resources for my CT3 year, despite the variety of excellent resources out there. I hope this website will help point you in the right direction. I'm not a PEM expert, but am following the guidance CEM have issued (in the form of a syllabus) to put together this page. This page is not endorsed by CEM, and any mistakes are mine.

Please comment with corrections, additions and further suggestions.

All the information here is collected from the internet, and it might be out of date or inaccurate, so please use your judgement and adhere to your hospital's protocols. If you do notice any errors or omissions please comment so we can put them right!

To navigate, decide whether you want to start with a PMP or a PAP. You can then select which PMP or PAP you want to look at. You will then be taken to the summary page for that PMP, with links expanded topic collections. If you know what topic you want to look at already, click on the link on the right hand side.

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

No comments:

Post a Comment