Wall Suction Settings for Foreign Body Removal from a 2-Year-Old's Ear
For removal of a foreign body from a 2-year-old's ear, wall suction should be set at a low pressure of 100-120 mmHg to prevent damage to the delicate ear structures while maintaining effective suction.
Evaluation Before Attempting Removal
Before attempting removal with suction, assess:
- Type of foreign body (foam buddy) and its location in the ear canal
- Whether the object is visible and accessible
- Signs of infection, inflammation, or trauma to the ear canal
- Integrity of the tympanic membrane
Suction Technique Guidelines
When using wall suction for foreign body removal:
- Use the lowest effective suction setting (100-120 mmHg) to minimize trauma
- Select an appropriately sized suction catheter that can grasp the foam buddy without pushing it further
- Maintain direct visualization with an otoscope throughout the procedure
- Avoid blind suction attempts that could push the object deeper
- Consider using a cellulose wick to facilitate removal if the ear canal is edematous 1
Alternative Removal Methods
If suction is unsuccessful or inappropriate for the specific foreign body:
- Direct instrumental extraction using alligator forceps or Magill forceps under direct visualization 1
- Irrigation with body-temperature water (only if tympanic membrane is intact and object won't expand with water) 1
Important Precautions
- Avoid blind finger sweeps inside the ear canal 2, 1
- Do not use cotton swabs to remove the object as they may push it further 1
- Limit removal attempts to avoid causing trauma or pushing the object deeper
- Consider referral to an otolaryngologist after failed attempts or if the object is deeply impacted
Post-Removal Care
After successful removal:
- Examine the ear canal and tympanic membrane for any damage
- Apply topical antibiotics if signs of infection are present
- Schedule follow-up in 1-2 weeks if there were complications during removal 1
Special Considerations for Pediatric Patients
- Ensure proper positioning and immobilization of the child
- Consider sedation if the child is uncooperative and the procedure cannot be safely performed
- Use age-appropriate distraction techniques
- Have backup equipment ready in case the initial approach is unsuccessful
Remember that the American Academy of Otolaryngology-Head and Neck Surgery recommends against using excessive suction pressure that could damage the delicate structures of the ear canal or tympanic membrane 1.