Kids will swallow or poke up their noses, or into their ears the strangest things. I remember during my student days, I was doing a rotation in pediatrics when a 6 year old came into see us. I went in to take the history and her mom told me that her daughter had a very pungent odor to her, which she couldn’t get rid of.
I examined the patient and noticed that she was having some sinus congestion. The odor seemed to be coming from her mouth or nose, that was for sure. I went into the pediatric attending, presented the patient and she went into the exam room and asked this little patient, “okay, Annie, what did you do this time, did you stick something up your nose?”
I remember Annie looking rather coy and finally admitting she had stuck an eraser up her nose so that she could know what it felt like.
“Okay, well then the attending stated, you have a chore to do every day for the next two weeks. You’re going to have to blow your nose several times a day and blow hard. You’re going to have to blow out that rubber eraser you sniffed up your nose. Understood?”
Annie nodded “yes.”
Another small tyke of 3 years came into the emergency room while I was doing my rotation there and his mom said that he had swallowed his pet baby turtle. We asked how big the turtle was and the mom said it was about 2 inches in diameter. The 3 year was acting fine, we did an x-ray of his abdomen and there was the turtle in his stomach. This 3 year was sent to surgery to have the turtle removed due to the concern that the turtle could perforate the child’s stomach with his paws.
Yet, another pediatric patient I took care of was a 7 year old who was playing around with a quarter at lunchtime with her friends. She was showing off, when suddenly she started wheezing and having pain. Her father was called to pick her up and he brought her to me to see her emergently. I sent her for a chest x-ray after I examined her and the quarter was stuck in her esophagus (swallowing tube) about 1/3 way down towards her stomach.
Now the question became, ‘how to remove it?’ My supervising physician became creative and decided to try using the small tip of a foley catheter after she swallowed some olive oil so as to make it slippery. The foley tip balloon was inflated below the quarter and he was able to slowly wiggle the quarter back up to her mouth where she promptly spit it out.
When you work in pediatrics you have to be prepared for many things. You have to be inventive in retrieving foreign objects out of a child’s nose, ear canal, airway and esophagus.
Sharon Bahrych is a physician assistant who blogs at A PA View on Medicine.
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