Foreign Objects: Treatment

Small particles like sand may be removable without medical help, but if the object is not visible or cannot be retrieved, prompt emergency treatment is necessary. Trauma to the eyes can lead to loss of vision and should never be ignored. Before attempting any treatment, the person should move to a well-lighted area where the object can be more easily spotted. Hands should be washed and only clean, preferably sterile, materials should make contact with the eyes. If the particle is small, it can be dislodged by blinking or pulling the upper lid over the lower lid and flushing out the speck. A clean cloth can also be used to pick out the offending particle. Afterwards, the eye should be rinsed with clean, lukewarm water or an opthalmic wash.

If the foreign object cannot be removed at home, the eye should be lightly covered with sterile gauze to discourage rubbing. A physician will use a strong light and possibly special eyedrops to locate the object. Surgical tweezers can effectively remove many objects. An antibiotic sterile ointment and a patch may be prescribed. If the foreign body has penetrated the deeper layers of the eye, an opthalmic surgeon will be consulted for emergency treatment.

A number of ingenious extraction methods have been devised for removing foreign objects from the nose and ears. A bead in a nostril, for example, can be popped out by blowing into the mouth while holding the other nostril closed. Skilled practitioners have removed peas from the ears by tiny improvised corkscrews; marbles by q-tips with super glue. Tweezers often work well, too. Insects can be floated out of the ear by pouring warm (not hot) mineral oil, olive oil, or baby oil into the ear canal. Items that are lodged deep in the ear canal are more difficult to remove because of the possibility of damaging the ear drum. These require emergency treatment from a qualified physician.

Mechanical obstruction of the airways, which commonly occurs when food gets lodged in the throat, can be treated by applying the Heimlich maneuver. If the object is lodged lower in the airway, a bronchoscope (a special instrument to view the airway and remove obstructions) can be inserted. On other occasions, as when the object is blocking the entrance to the stomach, a fiberoptic endoscope (an illuminated instrument that views the interior of a body cavity) may be used. The physician typically administers a sedative and anesthetizes the throat. The foreign object will then either be pulled out or pushed into the stomach, depending on whether or not the physician thinks it will pass through the digestive tract on its own. Objects in the digestive tract that are neither irritating, sharp nor large may be followed as they continue on through. Sterile objects that are causing no symptoms may be left in place. Surgical removal of the offending object is necessary if it is causing symptoms.

A rectal retractor can remove objects that a physician can feel during physical examination. Surgery may be required for objects deeply lodged within the recturm.

— J. Ricker Polsdorfer, MD