# Foreign Body Removal- Nose

## Overview

This module describes how to remove a foreign object from the nose.

## Indications

## Contraindications

## Patient information and consent

Always verify your patient’s identity and obtain informed consent before proceeding.

### How do I explain this procedure?

“There is a foreign object stuck in the nose and I need to remove it, because it can cause infection, damage to the tissues in your nose, and bleeding.”

### What can my patient expect?

“Depending on what the object is I will either try to grab it or hook it out with an instrument. This will be uncomfortable and can even cause your nose to bleed a little bit, but it will not be painful.”

### What is my patient’s role?

“Describe exactly what the object is, as this will help me know how to remove it. Please try to remain very still during this procedure.”

## Preparation

You may use

0.5% phenylephrine

0.5% phenylephrine

Do not use in the case of a button battery as it may increase the leakage of acids.

(Neo-Synephrine) to reduce mucosal oedema.

### Documentation

### Equipment

The type of equipment will vary depending on the type of foreign body.

## Site & Positioning

The site of foreign body impaction in the nose is between the inferior turbinate and the septum. The best way to remove hard objects is with a Jobson-Horn probe. Soft objects are best grasped using Tilley’s forceps or crocodile forceps.

For small children, let an assistant or parent hold the child. Wrap the child in a sheet and sit them upright, facing you on the parent’s lap with the child’s legs restrained by the parent’s crossed legs. The parent holds the child’s body with one arm, and the child’s forehead with the other. Rest the back of the child’s head against the parent’s body.

## Procedure

Follow medical asepsis with non-sterile gloves.

## Troubleshooting

I am unable to remove the object

Re-examine the nose and, if the foreign body is still visible, try again. Try a third time before referral to a specialist.

The patient is too uncooperative and I want to sedate them.

Sedation is discouraged, as this reduces the gag and cough reflexes as airway protection.

I would like to try the suction technique, but I do not have wall suction.

You can use the bulb from a sphygmomanometer or the bulb from a pneumatic otoscope to provide suction.

## Risks

## References