Common Routes of Foreign Bodies

Sometimes foreign objects enter through accidents and sometimes the child has put them there. The most common entry points for foreign bodies include:

• Ears
• Nose
• Mouth
• Eyes
• Skin

Let’s take a look at each route and talk about how to handle each situation.

Nose

Foreign objects in the nose are like foreign objects in the ears. If you do not see the foreign object go in, you should suspect a retained foreign body in the nose if you see the following symptoms:

• Drainage from one side of the nose, especially if it smells bad
• Nosebleed
• Pain or discomfort
• Swelling to the nose

If you can see the object sticking out of your child’s nose, you may be able to remove it at home. However, there is a risk of pushing the object further past the sinuses, and then it may enter your child’s airway or gastrointestinal tract.

The safest choice for foreign object removal from the nose is to visit your pediatrician or urgent care. You will need to hold your child still while the healthcare provider performs the foreign body removal.

As with the ears, your child may need anti-inflammatory medication or antibiotics if an infection has developed from the object.

Mouth

Small children often swallow foreign objects because they explore their world with their hands and mouths. While most swallowed items pass through their system without any complications, some require emergent care.

If the foreign object is a battery, magnet, or sharp, you should seek medical assistance at the emergency department. These objects may require surgery for removal and wound exploration.

You should also go to the emergency department or call 911 if your child is:

• Bleeding from the rectum
• Choking (object may be stuck in the esophagus)
• Drooling
• Having trouble breathing (object lodges in the airway)
• Speaking with a hoarse voice or wheezing
• Vomiting

Foreign objects through the mouth have two possible paths:

• They can be ingested, meaning they are swallowed and will enter the gastrointestinal tract or
• They can be inhaled, meaning they will enter the respiratory tract.

Inhaled (Respiratory Tract)

If you suspect your child has inhaled a foreign object, such as food, you may try to remove it at home by trying these two methods:

• The Heimlich maneuver. Stand or kneel behind your child with one fist on their abdomen and the other hand over your fist. Then pull your fist back towards you in an upward movement to propel the item out.
• Back blows. Sit in a chair with your child on their stomach on your legs, and their head in a downward position while you administer four to five back blows to propel the item out.

If these methods do not work, take your child to the emergency department. The standard care for an inhaled foreign body removal is bronchoscopy. This procedure involves placing your child under anesthesia and putting a scope into their respiratory tract to locate and remove the foreign object. Your child will receive antibiotics to help prevent aspiration pneumonia.

Eyes

Most foreign objects in the eyes are acquired by accident. Airborne particles may get into your little one’s eyes, but they are usually flushed out by tears and blinking.

If your child has continued eye irritation, they should visit the pediatrician or urgent care for further evaluation.

If you have been in an accident and suspect there is any glass or metal in your child’s eyes, visit the emergency room immediately.

Skin

Accidents usually cause foreign objects in the skin. The most common foreign objects are glass, metal, and wood splinters, usually in the soft tissue on their hands.

If your child has a splinter, you may remove it at home.

• Clean the area with soap and water. Avoid using hydrogen peroxide, iodine, or rubbing alcohol, as these will increase pain and slow healing.
• Wash your hands with soap and water.
• Use a clean pair of tweezers sterilized with rubbing alcohol and let them dry.
• Using the tweezers, grasp the splinter as close to the skin as possible and pull it out in the same direction it entered.
• Wash the area with soap and water again.
• Apply a thin layer of over-the-counter antibiotic ointment and a band-aid over the area to prevent infection.

Check with your pediatrician or urgent care if you are unsure of your child’s tetanus immunization status. They may need a booster.

The area with the splinter should heal quickly. If the wound is not healing or you notice signs of infections, like fever, redness, and swelling, visit the pediatrician or urgent care. A fragment of the splinter may still be under the skin.

How To Prevent Foreign Bodies in Kids

The best ways to prevent foreign bodies in kids is to:

• Avoid foods commonly inhaled or lodged in the throat, such as cherry tomatoes, grapes, hard candy, hotdogs, nuts, and popcorn.
• Keep small items out of reach, especially sharp items, button batteries, and magnets.
• Remind older siblings not to share their smaller toys with younger siblings.
• Teach your child not to laugh, play, or talk while eating, which can lead to food inhalation.
• Teach your child not to place things in their ears, nose, and mouth.