Nasal foreign bodies in the paediatric emergency department

Lisa Dann1, Jaime Doody2, Ruth Howard3

  • 1Emergency Department, Our Lady's Children's Hospital Crumlin, Drimnagh Road, Dublin 12, Ireland. lisa_dann@hotmail.com.

Insights

Emergency department (ED) staff successfully managed most pediatric nasal foreign body (FB) cases. Developing national guidelines can improve patient care and minimize complications during FB removal.

Area of Science:

  • Pediatric Emergency Medicine
  • Otolaryngology

Background:

  • Nasal foreign bodies (FBs) can cause irritation, inflammation, mucosal erosion, and aspiration risk.
  • Effective management in the Emergency Department (ED) is crucial for pediatric patients.

Purpose of the Study:

  • To describe the management protocols for nasal FBs in a tertiary pediatric ED.
  • To evaluate the success rates and methods of FB removal by ED staff.

Main Methods:

  • Retrospective study of 100 pediatric patients with suspected nasal FBs.
  • Data collected included patient demographics, FB type, removal techniques, and outcomes.
  • Analysis of interventions by ED staff versus Ear, Nose, and Throat (ENT) specialists.

Main Results:

  • 78% of visualized nasal FBs were successfully removed by ED staff.
  • 16 cases required referral to ENT for removal, with some managed in the ED and others in outpatient clinics.
  • The median age of patients was 3.4 years.

Conclusions:

  • ED physicians and advanced nurse practitioners effectively managed the majority of pediatric nasal FB cases.
  • Minimizing complications and repeated removal attempts is a key management goal.
  • National guidelines for topical anesthetic use, imaging, and limiting removal attempts are recommended to enhance care.
Abstract

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