What to do if a 20-month-old child has a foreign body (hamburger meat) lodged in their nostril?

From the Guidelines

If your 20-month-old child has hamburger meat lodged in their nostril, seek immediate medical attention at an urgent care center or emergency room, as attempting removal at home can push the object further in and cause more harm 1. When a child has a foreign body, such as hamburger meat, stuck in their nostril, it's essential to prioritize their safety and avoid causing further complications.

• The "mother's kiss" technique, which involves gently puffing air into the child's mouth while closing the clear nostril, may be attempted, but with caution, as there is limited evidence to support its effectiveness in such cases.
• It's crucial not to probe the nostril with tweezers or other objects, as this could push the meat further in or damage the nasal tissue, leading to increased morbidity and potential mortality 1.
• The child should not be allowed to sniff forcefully, as this could move the object deeper into the nasal passage.
• While waiting for medical help, keeping the child calm and preventing them from pushing the object deeper by avoiding nose picking is vital.
• Medical professionals have the necessary tools and expertise to safely remove foreign objects from the nostril, and their intervention is critical in preventing potential complications, such as infection or further airway obstruction 1.

From the Research

Nasal Foreign Body Removal in Children

• Nasal foreign bodies, such as hamburger meat, in children are a common issue in pediatric emergency departments 2, 3.
• The age of the child in question (20 months) is within the typical range for such incidents, although most cases occur in children between 2 and 4 years old 2.
• Various techniques can be used for removal, including positive-pressure expulsion, direct mechanical extraction with tools like forceps or balloon-tipped catheters, and washing out the object with nasally applied saline 2, 3.

Removal Techniques and Considerations

• The choice of removal technique depends on the type of foreign body and may require skill in numerous methods 3.
• Serious complications can arise from nasal foreign bodies, including posterior dislodgement, aspiration, trauma, infection, and choanal stenosis 2.
• In some cases, especially with certain types of foreign bodies like magnets or button batteries, emergent removal is necessary to prevent serious complications like septal perforation or necrosis 2.

Anesthetic Management and Safety

• For some children, removal of nasal foreign bodies may require general anesthesia to ensure safe management of the airway and prevent complications like aspiration 4.
• The goal of management should be to minimize complications and repeated attempts at removal, emphasizing the need for careful consideration of the removal technique and potentially the involvement of specialized care like otolaryngology consultation 5.

Prevention and Timely Extraction

• Nasal foreign bodies are generally harmless but can lead to complications if overlooked or if certain types of objects (like button cells) are involved, highlighting the importance of timely extraction and prevention 6.
• Education on prevention and guidelines for removal can improve patient outcomes and experience, suggesting a need for national guidelines to assist in emergency department removal and care 5.