It has been, and remains, my belief that pediatric patients create more stress for pre-hospital providers than any other patient group.  Most of us can say we would rather manage any other call than one involving pediatric trauma.  With that in mind we will address a lighter subject this week.

You Put it Where, is a subject involving children and foreign bodies.  Whether it is the result of their curious nature, poor judgment, a sibling or any number of factors, foreign bodies and children frequently come together.  The nose, mouth or ears all represent common destinations.  While these situations are usually not life-threatening, they can produce unnecessary stress on parents and patients alike.

In the ear, ease of access, and the fact that everybody comes with a standard issue of two ears, makes this location attractive.  Common offenders found in the ear include beads, nuts, stones, and beans, as well as toys and toy parts.  If unable to remove it with ease, its off to the ER where a combination of care must be rendered.

Up the nose, with this orifice, the most common offenders include beads, nuts, seeds, peas, beans, erasers, paper and jewelry.  If the object has remained in the nose for some time the child will have a foul odor and/or discharge coming from the nose.  Swelling, nose bleeds and sores are all possible downsides depending how long the object has been lodged in the location. Unless the object is visible , again, it is time to cruise over to the ER.

Button batteries are not to be fooled with.  Should you suspect that the object is a button battery, the child needs to be taken the emergency room, as immediate removal is indicated.  Regardless of the location, if the battery begins to leak, potentially serious alkaline burns can be expected.

Foreign bodies in the lower airway, generally speaking, will be in an age range of 6 mos to 5 years, with most being under the age of 3.  The leading offender is peanuts, hot dogs, coins, and again, beans and beads (popular items) can all become lodged in the lower airways.  While rarely  witnessed, most patients will have a history of coughing episodes.

It is important to keep a child at ease if you are to be successful with your examination efforts. 

To quiet a crying infant, a pacifier or bottle will usually do the trick.  If you believe your child has placed any  items in an orifice and you are unable to remove it readily and easily a visit to the ER is a must