Sunday, April 21, 2013

Help! My child has ___ up his nose!

Help! My child has ___ up his nose!

If you've ever said these words, you know how awful it can be to know your little one has something stuck up there but cannot blow it out. The longer it has been there, the more chance there will be secondary complications, such as irritation to the nasal mucosa ("skin" in the nose) or infection.

Sometimes the first sign of  something in the nose is a foul smell to their breath and thick yellow or green discharge from only one side of the nose. This is due to infection from the body's rejection of the object. (Usually a cold or allergies affects both nostrils, right?) These kids should be seen by their doctor (or midlevel provider) for further evaluation and treatment.

Sometimes you are lucky enough to find out about the foreign object soon after it is placed up the nose, before complications arise. But even then, how do you get it out?

Some parents feel most comfortable with a medical professional removing it. That is fine. Come in to our office and we'd be happy to help.

But if you want to try to get it out at home, there is a really good trick I learned from an ER doc friend long ago: blow it out for them. This is something you can try at home or in our office if you're nervous or unsure how to do it. (Never try to reach up there with something to pull it out... you might push it in higher and get it stuck in a turbinate-- see picture below.)

The basic problem is kids who put things up their nose don't usually have the ability to blow hard enough to get it out. If you blow into their mouth you can often force the object out. (Think of CPR, only you don't block the nose to force the air into the lungs- that would be bad!) 

It is important to not block the exit from the other nostril and not to do this if something is up both nostrils. There are those kids... We don't want to force the air into the lungs and cause problems there!

We often put Neo-Synephrine in the nose to shrink the nasal passageways to make it easier for the object to be blown out, especially important if the object has been there awhile and there is mucosal swelling. Be sure to keep your child calm because if they are crying they can suck the object in further. Blow into the mouth with a quick puff of air. This forces air up the back of the throat into the nose. This can be repeated several times if not successful at first. The parent usually ends up with a cheek full of mucus along with the object!

Of course, if this fails, you will need to bring your kiddo in to be evaluated. Sometimes with fancy tools we can remove the object. If it is deep into the nose or into the turbinates, an Ear Nose and Throat specialist might be required.

As always, prevention is the best cure. Keep small things away from kids and when they are working with craft beads, eating corn, playing on a gravel road, or otherwise in the vicinity of small objects, keep an eye on them!

Photos from Shutterstock.

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