Ear Foreign Bodies
If at first you don’t succeed, try again. But consider changing the technique of removal. Remember the law of diminishing returns - Allison Kornblatt
image by: Pixabay
HWN Suggests
Train Yourself: The Inside Scoop on Removing Foreign Bodies
There are numerous techniques for the removal of ear canal foreign bodies and most require fine motor skills. Some, such as the use of the Miller 0 laryngoscope for visualization, are less commonly known and practiced.
Holding the Miller 0 blade in your non-dominant hand, carefully insert the blade along the superior anterior portion of the external canal and gently lift up to open and illuminate the canal. Use your dominant hand to extract the foreign body using the chosen instrument.
Resources
Ear Foreign Body Removal
Which piece of equipment to use will be influenced by the type of FB, the shape of the FB, the location of the FB and the cooperativeness of the patient.
Ear, Nose, Inhaled and Ingested Emergency Management in Children
Foreign body insertion, inhalation and ingestion are common in the paediatric population with a peak incidence between 6 months and 3 years. Episodes are particularly prevalent in children with a history of pica, developmental delay or autistic spectrum disorder.
POTD: Foreign bodies, Ears!
Pearls on insect FB: Kill it first. They will fight. What to use? Lidocaine jelly, viscous lidocaine (2%), lidocaine solution, isopropyl alcohol, or mineral oil.
Trick of the Trade: Ear Irrigation in the Emergency Department
This set up for irrigation has been evaluated in the literature. Kumar et al looked at the pressures generated using this technique in vitro and found it appropriate for use in patients without increased risk of tympanic membrane perforation.4 The pressures generated do not exceed the pressure needed to cause perforation.
Ear Foreign Body - Pediatrics
Without question, kids will put the oddest objects into their orifices… and then say that they don’t know how they got there. While this can lead to same comic relief to your otherwise stressful shift, managing a foreign body can also generate its own level of stress.
Ear, Nose, and Throat Foreign Bodies
A small amount of viscous lidocaine can be a helpful local anesthetic. However, sedation may be needed in younger pediatric patients. Several common options include: Intranasal midazolam 0.3-0.5 mg/kg Oral midazolam 0.5 mg/kg Ketamine IV 1 mg/kg or IM 2-3 mg/kg
Pediatric Foreign Bodies
Common sites include the ear and nose, as well as the respiratory and GI tracts.
Search & Rescue of Ear Foreign Bodies – Picking the Right Tool
The first attempt at removal is the best, so it is important to make it count. Similarly, different types of foreign bodies call for different “tools” for removal.
Train Yourself: The Inside Scoop on Removing Foreign Bodies
There are numerous techniques for the removal of ear canal foreign bodies and most require fine motor skills. Some, such as the use of the Miller 0 laryngoscope for visualization, are less commonly known and practiced. Familiarity with these techniques allows a physician to select the one best suited for the removal of each unique foreign body.
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