Foreign bodies - nose and airway

Foreign bodies in the nose

Objects put into the child's nose are usually soft. These include tissue, clay, and pieces of toys or erasers. Children often place objects in their noses because they are bored, curious or copying other children.

What are the symptoms of foreign bodies in the nose?

The most common symptoms of a nasal foreign body are nasal drainage and foul odor on the side of the nose with the object. The nose may bleed.

Treatment

Treatment of a foreign body in the nose involves prompt removal of the object by your child's physician. This may be performed in the hospital, depending on the extent of the problem and the cooperation of the child. Sedation may be necessary. Techniques that may be used by your child's physician to remove the object from the nose include:

• Suction machines with tubes attached; this can be noisy
• Instruments inserted in the nose

After removal of the object, your child's physician may prescribe nose drops or antibiotic ointments to treat infection.

Foreign bodies in the airway

Foreign bodies in the airway constitute a medical emergency and require immediate attention. Foreign bodies in the airway account for nearly 9 percent of all home accidental deaths in children under 5 years of age.

As with other foreign body problems, children tend to put things into their mouths when they are bored or curious. The child may then inhale or choke and the object may become lodged in the trachea (windpipe) instead of the swallowing tube (esophagus). Food may be the cause of obstruction in children who do not have a full set of teeth or children who simply do not chew their food well. Children between the ages of 7 months and 4 years are in the greatest danger of choking on small objects, including, but not limited to, the following:

• Nuts, especially peanuts
• Hot dogs
• Seeds (watermelon, sunflower)
• Toy parts (usually plastic)
• Grapes
• Pebbles
• Buttons

Small children need to be watched very closely to avoid a choking emergency and should never be given nuts.

What are the symptoms of foreign bodies in the airway?

Foreign body ingestion requires immediate medical attention. Symptoms may include:

• Choking or gagging when the object is first inhaled
• Coughing
• Wheezing (a whistling sound, usually made when the child breathes out)

Although the initial symptoms listed above may subside, the foreign body may still be obstructing the airway. The following symptoms may indicate that the foreign body is still present in the airway:

• Stridor (noisy breathing)
• Difficulty breathing or rapid breathing
• Cough that gets worse
• Child is unable to speak
• Pain in the throat area or chest
• Hoarse voice
• Blueness around the lips
• Not breathing
• The child may become unconscious

Some time after the child aspirates or chokes on the foreign body, all symptoms may resolve and the toddler seem perfectly normal. It is very risky to assume that the foreign body has been coughed out, particularly if nuts are involved. The child should be evaluated by a physician.

Treatment

Treatment of the problem varies with the degree of airway blockage. If the object is completely blocking the airway, the child will be unable to breath or talk and his/her lips will become blue. Perform the Heimlich maneuver and call 911. If the child can breathe, this is a medical emergency and you should seek emergency medical care immediately.