An object lodged deep within the nasal cavity is a common occurrence, particularly among young children. This situation requires an immediate, calm, and cautious response to prevent serious complications. Anxiety can cause a person to sniff or inhale deeply, risking the object moving further back into the nasal passage or even into the airway, creating a dangerous aspiration risk. Improper attempts to remove the object can push it deeper, making professional removal more difficult.
Safe Techniques for Immediate Removal
If the person is old enough to follow simple directions, the first gentle intervention to attempt is the controlled nose blow technique. This method uses the body’s natural mechanism to create positive pressure, which can successfully expel the object without instrumentation. To perform this, instruct the person to sit upright and lean slightly forward over a towel or sink to catch the expelled item.
The unaffected nostril must be gently but completely sealed with a finger to ensure all air pressure is directed toward the blockage. The person should then blow gently but firmly through the affected nostril, similar to blowing out a single birthday candle. Forceful or repeated attempts should be avoided, as they can cause swelling and push the object further into the nasal cavity. This technique should be limited to one or two gentle tries.
For toddlers or young children who cannot cooperate with the nose blow technique, the “Mother’s Kiss” maneuver is an alternative. This technique works by generating a burst of positive pressure that travels through the back of the throat and into the nasal passage. To perform this, first reassure the child and then place your mouth over the child’s open mouth, creating a complete seal.
The parent must then firmly seal the child’s clear, unaffected nostril with a finger. The adult delivers a short, sharp puff of air into the child’s mouth, which forces the air into the nasopharynx and then out of the blocked nostril. This maneuver has a reported success rate of around 60% for appropriate cases and can be repeated once if the first attempt is unsuccessful and the child is not distressed.
Crucial Actions to Avoid
Attempting to retrieve the object with household items is strongly discouraged due to the significant risk of injury and displacement. Never insert objects like cotton swabs, matchsticks, bobby pins, or household tweezers into the nasal passage. These items can push the foreign body deeper into the nose, complicating its removal and potentially causing trauma to the delicate nasal lining.
Probing the object with a finger can cause swelling of the surrounding tissue, making the object more impacted and difficult to retrieve. Aggressive or uncontrolled nose blowing can also propel the object backward. If the object is pushed beyond the nasal cavity, it may enter the throat and be aspirated into the lungs, which is a life-threatening emergency.
It is also important to resist the urge to wash out the object with water or saline solutions. This action can cause certain organic materials, such as beans or seeds, to swell, leading to a tighter impaction. Additionally, fluids can increase the risk of the object being washed into the airway, creating a choking hazard.
When Professional Medical Help is Necessary
Seeking professional medical help is immediately necessary if the foreign body is a button battery or a magnet. Button batteries can cause an electrical current and chemical burn that leads to severe tissue damage, including septal perforation, in as little as two to four hours. Magnets can exert pressure on the nasal septum, causing tissue death between the magnet and any other metallic object nearby.
Any failure of the one or two gentle home-removal attempts should prompt a visit to an emergency room or urgent care facility. Immediate medical attention is also required if complications arise. These include persistent bleeding, an inability to breathe effectively through the nose, or any indication of infection, such as fever, facial swelling, or a foul-smelling, unilateral nasal discharge.
Medical professionals have specialized instruments. Techniques employed may include using a small, specialized instrument with a hook or a balloon-tipped catheter passed beyond the object to pull it out gently. In some cases, a suction device or even a specialized positive-pressure method may be used to dislodge the object under controlled conditions.