How do you manage foreign body sensation?

From the Guidelines

To manage foreign body sensation, a person should seek immediate medical attention if the sensation persists, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1. When a foreign body sensation occurs, it is essential to prioritize medical evaluation to rule out any severe conditions that may require immediate attention. The guidelines suggest that individuals with persistent foreign-body sensation in the eye should seek medical help promptly 1. Some key points to consider in managing foreign body sensation include:

• Identifying and removing the foreign object if visible and accessible
• Flushing the eye with sterile saline solution or clean water to wash out any particles
• Avoiding rubbing the eye to prevent corneal abrasion
• Using preservative-free artificial tears to lubricate the eye and help flush out any remaining microscopic particles However, the most critical step is seeking immediate medical attention for persistent symptoms, as emphasized by the 2024 guidelines 1. It is also important to note that foreign body sensation can be caused by various conditions, including dry eye, conjunctivitis, or corneal abrasions, and a medical professional can provide an accurate diagnosis and appropriate treatment. In cases where medical attention is sought, an ophthalmologist may prescribe antibiotic eye drops or other treatments to manage the condition and prevent complications. Ultimately, prioritizing medical evaluation and seeking immediate attention for persistent foreign body sensation is crucial to ensure proper management and prevent potential complications 1.

From the Research

Management of Foreign Body Sensation

To manage foreign body sensation, several approaches can be considered:

• Attempt to localize the foreign body by the emergency physician 2
• If initial attempt does not resolve the sensation, an ENT consult to remove the possible object should be initiated 2
• Radiological imaging, such as neck X-ray or CT scan, can be considered after failure by ENT 2
• Endoscopic management can be used to remove foreign bodies from the gastrointestinal tract, especially if the object is lodged in the esophagus or further down the digestive system 3
• A thorough physical exam and clinical history are crucial in making the diagnosis, and additional modalities like CT scan and diagnostic endoscopy may be necessary 3

Diagnostic Approaches

Different diagnostic approaches can be used to manage foreign body sensation:

• ENT consult for removal of the foreign body, with an average time to discharge of 188 min 2
• Neck X-ray followed by an ENT consult, with an average time of 327 min 2
• No imaging studies or consults, with an average time of 166 min 2
• Careful examination of the hypopharynx and neck, and flexible fibre-optic rhinolaryngoscopy 4

Considerations

When managing foreign body sensation, it is essential to consider the following:

• The location of the foreign body may not correspond to the location of pain reported by patients 5
• A comprehensive and thorough oropharyngeal examination should be performed to avoid misdiagnosis 5
• The positive predictive value (PPV) for the midline neck and above cricoid cartilage level can be higher than other areas 5
• Psychoanalysis and appropriate treatment may be necessary for patients who repeatedly introduce foreign bodies, especially children 6