UMEM Educational Pearls

Title: Trick of the Trade: foreign body removal

Category: Pediatrics

Keywords: dermabond, glue, foreign body, (PubMed Search)

Posted: 10/21/2011 by Mimi Lu, MD
Click here to contact Mimi Lu, MD

Next time you have a small round foreign body that you can't grasp with alligator forceps in the nose or ear.  Advantages: non-traumatic and easy to use. Disadvantages: foreign body must be visualized, adhesion of glue to patient
 
Technique
- apply a small amount of cyanacrylate (e.g. Dermabond) to the wood or plastic end of of a cotton-tipped applicator 
 - under direct visualization, slowly advance the tip until contact is made with the foreign body and allow 30-60 seconds of dry time before extracting the object in a gentle smooth motion .
 
Helpful hints:
- This technique requires: a cooperative patient, good lighting, direct visualization and manual dexterity... if any of the these are missing, you may want to consider an alterative method.-
- The foreign body should be dry and easily visualized so that the risk of accidental contact with the mucosa or tympanic membrane is avoided.
 
Picture submitted by Dr. Adam Friedlander
 
 
Reference:
Davies P and Benger J. Foreign bodies in the nose and ear: a review of techniques for removal in the emergency department. J Accid Emerg Med 2000;17:91–94