foreign-body-removal

Foreign Body Removal – Precautions Every Parent Should Take

Does your child have the frequent habit of pushing things up his nose or ear?

At their age, toddlers are curious by nature. Sometimes, you might have noticed your child putting a small object into their ear, mouth or nose if they are bored or have seen other children do the same.

If proper precautions are not taken, that object can end up in the wrong place and cause issues and force a parent to seek immediate medical help.

Consulting Dr. D.K. Mitra, Pediatric Surgeon at Sitaram Bhartia Hospital, for the first time? Please call us on +91 8826391002 for appointments.

Here is what Dr Mitra wants parents to know in order to be better prepared to prevent such situations and seek help in case of an emergency.

1. Foreign Body In Ear

The first step to take into account is keeping small objects (like parts of toys, nuts, beads, etc), out of the reach of children younger than 4 years of age.

“Small objects like food, insects, or buttons can go undetected and easily find their way into a child’s ear,” says Dr. Mitra.

Foreign body in ear symptoms include:

  • Pain
  • Redness
  • Infection
  • Ear discharge
  • Difficulties in hearing

Wondering how do you get something out of your child’s ear? Keep in mind these simple tips:

  • Do NOT probe the ear with an ear bud, cotton swab, bobby pins or bent wires as you may risk pushing the object farther into the ear canal.
  • Try washing the object out with some warm water, or using a lubricant like oil.
  • If the object is visible, you can try gently removing the object with tweezers.
  • It is better to take the child to a hospital for expert care and advice.

Noticed your child experiencing ear discharge, failing to respond to you calling out their names, or his/her performance at school deteriorating? This may indicate that the object is blocking the ear canal.

Don’t panic – consult a pediatrician or an ENT specialist immediately. In case of an emergency, call us at 011 4211 1197 and rush to our Emergency room to get assisted by a qualified pediatrician available around the clock.

2. Airway Obstruction

It often happens that children end up taking in foreign bodies accidentally while playing with them, which causes airway obstruction in children.

Most common objects that get into a child’s airway are peanuts, small pieces of nuts/food, or small parts of toys – most commonly a whistle! In rare cases, screws or other metal objects have also been seen.

The airway is divided into upper (nose, mouth, larynx) and lower (windpipe, bronchi,) respiratory tract. Foreign bodies getting stuck in any part of the airway can prove troublesome and become threat to their life.

“Cases of foreign body in nose are common amongst small children if they have access to foods, toys, chalk sticks or button batteries. Food like parts of grapes or nuts, or whole seeds also tend to get stuck in the throat in babies if they haven’t developed a full set of teeth.”

Typically a foreign body entering a child’s mouth travels to their stomach and tends to get excreted naturally. However, objects taken in due to ‘forceful inspiration’ such as a sudden inhalation after a cough, while the food is in mouth can get it lodged in the child’s airway.

A child with an airway obstruction may present with the following symptoms:

  • Sudden, violent bouts of coughing
  • Wheezing or noisy breathing
  • Choking or gagging
  • Struggling to breathe
  • Vomiting
  • Turning blue
  • Un-resolving pneumonia

Every year, thousands of children are rushed to the Emergency Room for airway obstruction, and a majority of these children are 4 years or younger.

A. Foreign Body In Nose

Keep in mind these points if you notice a foreign body in child’s nose –

  • Do not panic visibly in front of your child and give them instructions in a calm manner
  • Urge the child to breathe through their mouth instead of the nose in order to avoid pulling the object further into the nasal cavity
  • Do NOT inspect the object with a cotton swab as you might push it upwards into the nose

B. Airway Foreign Body

If a foreign body is suspected after a clinical examination in the ER, a chest X-Ray will be advised to figure out where and what has been taken in. It helps the doctor if a sample of the likely foreign body is carried to the doctor for visual inspection.

Parent should remember that at times foreign body may be small and symptoms are produced late, usually in the form of unresolving pneumonia.

Once the diagnosis is confirmed, the possibility of using non-surgical methods to dislodge or take out the object are explored.

Keep in mind that the doctor may suggest a surgical procedure in order to remove the foreign body in nose, ear,or food pipe etc if non-surgical methods like catheter extraction do not work.

“Treatment of the foreign body differs depending on its location.”

“Airway foreign bodies can be particularly tricky. In cases of airway obstruction, a bronchoscopy will need to be performed to remove the item. It is a safe procedure where a scope is inserted to find the object and forceps are used to remove the item.”

“A foreign body removal of the ear is also prompt and safe, where instruments are used to suck out or retrieve the object. After removal, the ear is re-examined for any injuries and ear drops are prescribed to prevent infection.”

At times, vegetable matter can induce infection or pneumonia. But in most cases, once the procedure is carried out, the child recovers quickly.

C. Swallowed Foreign Body:

A swallowed foreign body which is round or without sharp edges and less than 2 cm is usually expelled naturally during excretion. The child should be brought to the Emergency Room to locate the foreign body for future reference or for checking progress of the object.

After a medical consultation, the child will be advised to remain on a semi-solid diet like bananas, rice, etc. to help propel the object down. Usually an object is expelled within 4-7 days. If not then he should be examined again to ascertain progress of the object.

Should the child develop abdominal pain, vomiting or fullness of abdomen he should immediately be rushed to the hospital.

Accident Prevention Tips For Parents

  1. Keep Choking Hazards Out of Your Child’s Reach

Ensure that the child engages with age-appropriate objects and toys that do not have removable small parts.

Small items such as coins, marbles, buttons, or button batteries should also be kept away from them as they can become choking hazards. These can easily lodge in a child’s ear, nose, or may be swallowed, if precautions are not taken.

Suffocation hazards such as necklaces, ribbons or drawstrings should also be kept away from young kids as these may make them prone to strangulation.

Many times, clothing garments with beads or decorative bead necklaces can also become a source of choking hazards. Children may pick up the habit of picking at their mother’s dresses and putting the beads into their mouth.

It is, thus, important to be careful and minimize the child’s exposure to such items.

2. Supervise Your Child’s Feeding

This is important, especially in young children, as many cases of foreign body in airway are food items.

Supervise what your child is eating. Make sure they are seated when they have food in their mouth and do not talk, play or cry while eating.

The American Academy of Pediatrics (AAP) recommends that children of age 4 and younger should be fed firm foods only if they are cut into small pieces. Avoid feeding them any form of hard candy, chewing gum, whole seeds like peanuts, uncut grapes or raw carrots.

Be careful when feeding a child with a cough or breathing difficulties such as wheezing.

3. Carefully Reason With The Child

At times, despite precautions, accidents might occur or children might put objects in their nose, mouth or ears for play.

It is important to note that yelling at them will be counter-productive. Gently explain to the child why they should not put things in their body’s orifices and repeat this conversation every time you catch them.

FAQs Related To Foreign Body Removal

Here are some questions frequently asked by worried parents at their consultations –

How do I remove a foreign body from my child’s ear at home?

You may try to irrigate the ear canal with warm water or use a lubricant such as oil to make it easier for you to remove the object. If the small object is visible, you can try removing it using a pair of tweezers or forceps as well.

Keep in mind that you should stop immediately and consult a pediatrician if the object moves further into the child’s ear canal.

How do you get a foreign body out of your throat?

Every parent should be conversant with Heimlich maneuver which is a first-aid procedure for dislodging an obstruction from a person’s windpipe. One gives a sudden thrust to the upper abdomen of the child to dislodge the foreign body stuck in throat or airway.

In mild cases, you might be advised to wait and watch if the foreign body is swallowed and then excreted naturally.

If the condition turns serious then the child should be taken to a hospital where an endoscopic surgery can be performed to remove the object from the throat. This is done under general anesthesia and the child will be discharged within the same day.

How is a foreign body removed from the eye?

Wash the affected eye in order to flush the object out. Do NOT rub or put too much pressure on the eye as it will be unhelpful and may damage the eye.

Prompt treatment is the key to avoiding infection and other serious complications so take your child to the pediatrician if the problem persists.

How long does it take for a foreign body to pass through the digestive system?

Since young children have the natural tendency to put things in their mouth, they are more prone to ingesting objects they should not be.

In most cases, the digestive system can process the swallowed foreign object within the span of 7 days and excrete it naturally. If the object gets stuck, or other symptoms develop, surgery might become necessary.

Be cautious about ingested button batteries or multiple small magnets which are very harmful and may have serious consequences once ingested. Immediate medical attention should be sought if they are.

How to avoid home accidents or injuries?

Children have the natural tendency to explore their surroundings, which may cause them to harm themselves. It is a parent’s duty to make their home accident-proof for the child using these simple rules:

  • All cupboards, drawers, almirahs, kitchen cabinets, refrigerator should have child lock that prevents accidental opening and unintentional incarceration by a child.
  • All electrical sockets should be child proof i.e. covered with commercially available plastic covers.
  • After cooking food, turn off the heat source. Turn the handle of the utensils away from outer edge so that the child cannot grab it.
  • Do not carry a child and hot liquid together.
  • A radiant heater should have a small mesh grill in front so as to prevent a child from pushing objects or his finger through.
  • Always check the bath water for suitable temperature with the back of your hand before bathing the baby.

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