Removal of an embedded crochet needle in the mouth

A 3-year-old child presented to the emergency department with a crochet needle lodged in her posterior oral cavity. To localize the needle and significant surrounding anatomic structures, bedside transcavitary ultrasound was employed. After careful localization, the needle was removed using a modified needle cover technique. A review of barbed foreign object removal techniques, including advance-and-cut, retrograde, string-yank, and needle cover techniques, is presented. Important considerations while planning any procedure include risk, benefit, availability of staff, and availability of equipment. Proper anesthesia is paramount to the success of these procedures, and sedation in pediatric patients may prove necessary. Postprocedure wound care and follow-up must also be arranged. This case demonstrates the importance of adaptation of well-documented techniques to remain flexible for any situation that may present to the emergency department.