Monday, April 25, 2011

Nasal Foreign Body: Up your nose and around the corner.

I am back in an inner-city emergency department. And it's been a while since I have posted anything to my blog. Life has been a little crazy. But as Aerosmith once said back in the early 80s "I'm back in the saddle again".

This emergency department is in the heart of an inner-city and what some would call a knife and gun club. That means that there are gunshot wound victims knife stabbing victims and people who suffer all forms of trauma abuse and other accidents. I will have to catch you up later on a lot of the details nevertheless I have seen some amazing cases during this rotation so far.

On a lighter note the other night while working at 2:00 in the morning a very sweet nice little five-year-old girl presented to the emergency department with her father with a chief complaint of a foreign body in her nose. That is just medical mumbo-jumbo for she got something stuck up her nose.  As I entered the exam room and saw this cute scared little five-year-old girl who thought for sure she was going to get some sort of a shot. I couldn't help but think of how scared she was and how concerned her father was not sure if he was concerned or mad or maybe a little of both.

I asked the patient how she got something stuck up her nose or what was stuck up her nose to which she replied with big alligator tears in her eyes I don't know and I don't know, which is a fairly typical response. I was able to further question her and explain that she was not in any trouble that I was there to help her and that we see these these things all the time with not just kids but also with adults. After making a few more jokes and getting her to laugh she finally admitted that she was playing with some toys and accidentally put a plastic bead up her nose.

I was able to take a very small tiny balloon catheter, after anesthetizing her nose and slide the balloon catheter pass what appeared to be a black bead and inflate the balloon.  Then ever so gently I pulled back on the catheter bringing with it the small black ball that she had somehow put up her nose.  Everybody in the room clapped and cheered. This was a very rewarding case. I immediately proclaimed "Popsicle stat" and the nurse magically appeared with an orange popsicle (the patient's favorite flavor) and all was well at three in the morning for this five-year-old girl and her father.


I love my job.