A child has retained disc battery in the nose. What is the most impoant consideration in the management?
Ans. a. Battery substance leaks and cause tissue damage Most impoant consideration in the management of retained disc battery in the nose of a child is the leakage of battery substance leading to tissue damage. `If the FB is a small button battery, moisture within the cavity may lead to tissue damage. Irrigation or nasal wash should not be used. If the battery leaks, there may be liquefactive necrosis and organ injury. It should be removed immediately.'- http://wwwpatient.co.uk/doctor/nasal-injury- and-nasal-foreign-bodies Professional Reference `Examine for signs of other FB e.g., nasal, ear, inhaled, etc. Refer to ENT specialist if unsuccessful after two attempts.' Management of Nasal Foreign Body Before you sta, make sure you have the correct equipment and that the child is being adequately held, in an accommodating position. Fewer attempts will reduce the anxiety of the parent and child. Use topical anaesthetic and vasoconstrictor (reduces swelling) spray in the affected nostril. Blow positive pressure through the nose - preferably by the parent blowing sharply through the child's mouth whilst obstructing the unaffected nostril. This has been shown to be relatively non-traumatic, with success rates of 79% Use a nasal speculum and a hook or thin forceps, to hold object. Be careful not to push the FB fuher back Application of strong suction is sometimes sufficient to draw the object out. Pass a narrow balloon catheter past the FB, inflate and remove the catheter, pulling the FB with it. The Fogay is preferred (compared to a Foley), as it is stiffer and stronger. Examine for signs of other FB e.g. nasal, ear, inhaled, etc. Refer to ENT specialist if unsuccessful after two attempts If the FB is a small button battery, moisture within the cavity may lead to tissue damage. Irrigation or nasal wash should not be used. If the battery leaks, there may be liquefactive necrosis and organ injury It should be removed immediately. After successful removal of a nasal FB, careful examination of the involved nasal cavity as well as the other body Paicular attention must be paid to the examination of the ear and sinuses on the involved side, as acute otitis media
Battery substance leaks and cause tissue damage
It can lead to tetanus
Refer the child to a specialist for removal of battery
Instill nasal drops