I said to her, “Why don’t you go see the patient first and we will discuss steps to remove it afterwards?” 

She smiled and proceeded to the room where I could already hear cries emerging from.

As I waited for the Resident to obtain some history, I glanced through the department census for patients who were yet to be seen. I could help the other pod and get patients moving; but I got distracted.

In the children’s ED, it’s not unusual to get distracted by the cries and laughter of children. Sometimes it’s hard to know who is crying due to pain or discomfort; or from stranger anxiety during the usual examination or the child that just doesn’t want to be held back in the room.

Nonetheless, I was mostly distracted by the cry from room 28, the room with the toddler coming in for foreign body in her nose. I assumed she was being examined by the Resident and it could be the typical ‘stranger-danger’ cry. However, the cry didn’t stop. It got louder and louder and I became more concerned about her being in pain.

I decided to check in and see if the Resident was attempting the removal herself. She hadn’t done it before but maybe she decided to give it a try first. I poked my head in the room to see if my Resident needed help but there was no one in there besides the patient and her mother.

The little girl with her ear-splitting cry was standing half-way across the room, pulling her mother by her clothing and pointing towards the door. She didn’t appear to be in pain but she wanted something. 

I hadn’t met this family yet so I quickly introduced myself and asked the mother, “Does she want something? Do you think she’s in pain?”

 Mother replied with a chuckle, “she doesn’t need anything.” Then with uncontrollable laughter, mother said, “she’s not in pain, she just wants me to open the door so she could go play and watch the aquarium in the waiting room” 

 My eyes wide open in surprise, my jaw dropped but I quickly closed it. That’s why she’s been crying all this time? 

“Not yet little lady,” I said. “Let me get the other doctor so we can get the sponge out and set you free.” 

The struggle

I went back and gathered a team because I knew we would need help. We resorted to a bed sheet papoose and wrapped her into a little human burrito. 

After what seemed like a battle between 4 adults and a feisty little human we were able to keep her steady. 

Then with multiple nasal suctioning tries to get the foreign body close enough to be seen and use of a tweezer, we successfully pulled out a small makeup sponge from her right nose. A little trickle of blood followed but stopped immediately after a little pressure was applied. 

We had barely removed all the sheets used in the papoose when she jumped off the bed and hugged her mother so tight, hoping not to be snatched away, continuing with her loud cry.

Nevertheless, it didn’t last long, as it slowly faded in to smile at the sight of the popsicle of ‘truce’ the nurse provided. 

“That ended well,” I smiled as I looked at my Resident.  “Another successful procedure, another happy child.”

We then turned to mother for some education and discharge instructions

Safety tips

Home removal attempt

• A safe alternative to attempt at home is the Mother’s kiss (see video below)
• Call and check-in with your doctor first to be sure it’s ideal for your child’s age and/or medical condition.

Article also published on: 

Don’t forget to follow me on social media: