Emergency Department, Our Lady's Children's Hospital Crumlin, Drimnagh Road, Dublin 12, Ireland.
Department of Otorhinolaryngology, OLCHC, Dublin, Ireland.
Ir J Med Sci. 2019 Nov;188(4):1401-1405. doi: 10.1007/s11845-019-02000-z. Epub 2019 Mar 11.
Nasal foreign body(-ies) (FB) cause local irritation, inflammation, and mucosal erosion and carry a potential risk of aspiration. The aim is to describe the management of nasal FBs in our Emergency Department (ED).
A retrospective study of 100 sequential suspected nasal FB presentations to a tertiary paediatric ED. Patient age, gender, FB typology, doctor/nurse seniority, sedation/analgesia usage, removal method, ENT referral rate, extraction time and disposition were collected. Data was inputted to Microsoft Excel®.
One hundred cases were encountered over 16 months: 51 males and 49 females. Median age was 3.4 years (range 0.8-10). Of the 73 FB visualised in the ED, 78% (57/73) were successfully removed by ED staff. Sixteen visualised in ED required ENT removal. Of those 16 FBs, 7 were removed at OPD while 9 were removed by ENT in ED.
The ED physician/advanced nurse practitioner successfully managed most children with a nasal FB in the ED. The goal of the management should be to minimise complications/repeated attempts. Formation of a national guideline to assist in ED removal and timely care will hopefully improve patient's experience. It will include guidance on topical anaesthetic use, performing radiographs for radiopaque objects not initially visualised and limiting ED staff extraction attempts.
鼻腔异物（FB）会引起局部刺激、炎症和黏膜糜烂，并存在潜在的吸入风险。目的是描述我们急诊部（ED）对鼻腔 FB 的处理方法。
对 100 例连续疑似鼻腔 FB 就诊于三级儿科 ED 的患者进行回顾性研究。收集患者年龄、性别、FB 类型、医生/护士的职称、镇静/镇痛的使用、取出方法、耳鼻喉科（ENT）转诊率、取出时间和处置等数据。数据输入 Microsoft Excel®。
16 个月内共发现 100 例：男 51 例，女 49 例。中位年龄为 3.4 岁（范围 0.8-10）。在 ED 中观察到的 73 个 FB 中，78%（57/73）由 ED 工作人员成功取出。16 个在 ED 中观察到的需要 ENT 取出。这 16 个 FB 中，7 个在 OPD 取出，9 个在 ED 由 ENT 取出。
ED 医生/高级护士执业师成功地在 ED 管理了大多数有鼻腔 FB 的儿童。管理的目标应该是尽量减少并发症/重复尝试。制定一个全国性的指南，以协助 ED 取出和及时护理，有望改善患者的体验。它将包括关于局部麻醉剂使用、对最初未观察到的不透射线物体进行 X 光检查以及限制 ED 工作人员取出尝试的指导。
