Objects inserted:
(1) corn, pea or other small vegetable
(2) bead from toy jewelry
(3) small stone
(4) toys
Problems affecting removal:
(1) presence of airway obstruction
(2) excessive anxiety of the child (or parent)
(3) mucosal bleeding
(4) object difficult to extract (smooth, round, friable or hard, firmly impacted)
Positive pressure method for removal for an object occluding the nares:
(1) Have medical personnel retreat to a distance that makes the child feel safer.
(2) Tell the child that the parent will give them a big kiss.
(3) Have the parent hold the child in the lap and to obstruct the opposite nostril with a finger.
(4) The parent places his/her mouth over the patient's mouth and takes in a shallow breath, followed by a giving a rapid exhalation into the child's mouth. This should impart a positive pressure to the child's upper respiratory tract.
(5) If all goes well the object will fly out and probably strike the parent in the cheek.
(6) If the object is firmly impacted or the parent's exhalation is weak ("timid"), then a series of kisses may be necessary.
Objects that are difficult to remove may require:
(1) child restraint
(2) sedation or general anesthesia
(3) a specialist (ENT surgeon)
