A foreign body lodged in the nasal cavity occurs frequently, particularly in children between the ages of two and five. Small, round items like beads, seeds, and small toy parts are commonly placed into the nose. Recognizing this situation requires a calm and immediate response to prevent the object from moving deeper into the airway or causing localized damage. Remaining calm also helps reduce panic, which can lead to involuntary deep sniffs that might pull the object further back.
Initial Attempts: Gentle Techniques
When an older child or an adult is cooperative and understands instructions, the first attempt at removal should be a gentle, controlled nose blow. This technique aims to use the natural positive pressure of exhalation to push the object out of the affected nostril. The person should sit upright and lean slightly forward, which uses gravity to help keep the object from moving backward into the throat.
To maximize the force, the unaffected nostril must be completely sealed shut with a finger. Instruct the person to blow out gently but firmly through the blocked nostril, similar to blowing out a single candle. If the object does not dislodge after one or two controlled attempts, stimulate a sneeze, which generates significantly more expulsive force than a conscious blow. A sneeze can be induced by gently tickling the inside of the clear nostril with a clean tissue or by having the person smell ground pepper.
The Assisted Positive Pressure Method
For young children who are unable to cooperate and perform a controlled nose blow on demand, an assisted maneuver known as the “Mother’s Kiss” technique can be attempted. This method relies on an adult creating a positive pressure puff of air to dislodge the object. The child should be positioned so they are comfortable and restrained only enough to keep their head still during the brief procedure.
The adult should first place their mouth fully over the child’s mouth, creating a tight, firm seal similar to that used during mouth-to-mouth resuscitation. Simultaneously, the adult must use a finger to firmly close the child’s clear, unaffected nostril. With the clear nostril occluded, the adult then delivers a short, sharp puff of air into the child’s mouth.
This burst of air travels through the back of the throat and is forced up into the nasal cavity, creating a pressure wave that pushes the foreign object out. This technique is effective in approximately 60% of cases, often succeeding where a child’s uncooperative efforts fail. If the object does not come out, the attempt can be repeated once or twice, but seek professional help afterward.
Critical Safety Warnings and Actions to Avoid
Avoid several common, yet dangerous, removal methods that can turn a minor issue into a severe medical complication. Never attempt to probe the nasal cavity with household tools, such as cotton swabs, tweezers, or fingers. These items almost always push the foreign object deeper, making professional removal more difficult and increasing the risk of aspiration.
Encourage the individual to breathe through their mouth and prevent them from sniffing or inhaling sharply through the nose. A sharp inhalation can move the object from the nasal cavity into the pharynx and potentially into the airway, creating a life-threatening choking hazard. Objects like dried beans or seeds should never have water introduced into the nose. Water causes them to swell, leading to firm impaction and rapid tissue damage.
When to Seek Professional Medical Care
Seek immediate medical attention if the foreign object is identified as a button battery or a small disc magnet. Button batteries are an emergency because they generate an electrical current upon contact with moist nasal tissue. This rapidly causes chemical and thermal burns that can lead to severe tissue necrosis and a hole in the nasal septum within hours. Similarly, if two magnets are involved, they can attract each other across the nasal septum, causing pressure necrosis and tissue death.
If gentle home attempts fail or if symptoms develop, abandon the attempt in favor of professional care. Signs requiring immediate medical attention include persistent bleeding, inability to breathe effectively through the nose, or a foul-smelling, one-sided nasal discharge. This discharge can indicate a long-standing object or the beginning of an infection. A medical professional, such as an Ear, Nose, and Throat specialist or emergency room physician, is equipped with specialized tools like suction devices, forceps, and balloon catheters to safely extract the object.