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#2 

THE ANSWER IS C.

Nasal foreign bodies are perhaps the most common location for foreign bodies to be placed in the pediatric population. Common objects include beans, sponge pieces, pebbles, peas, plastic toys, marbles, and other small round objects. Patients who seek treatment for a nasal foreign body usually have one of two histories. Insertion of the nasal foreign body is witnessed by the parent or admitted by the child and results in immediate presentation to the ED. A delayed presentation often results in purulent, unilateral, malodorous nasal discharge or even persistent epistaxis. These patients are often misdiagnosed as having sinusitis and are treated with antibiotics. This may lead to “unresolving sinusitis” despite appropriate antibiotic therapy and should alert the emergency physician to the possibility of a nasal foreign body.

Compared with patients with ear foreign bodies, children with nasal foreign bodies tend to be younger (A) (<5 years of age). Most nasal foreign bodies occur in the right nare (B). Positive pressure removal techniques, such as “big kiss” from a parent or bag-valve-mask insufflation rarely leads to barotrauma (D).

Reference

Thomas SH, White BA: Foreign Bodies, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 57:p 719-720.

 

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