Management of foreign bodies in the nose

Clinical Guideline
Title: Management of foreign bodies in the nose
Document Author:

Sharon Rohleder

Date

September 2009

Ratified by:

Care and Clinical Policy
Group

Date:

16th September
2009

Review date:

September 2011

Links to policies: Consent policy , MIU history Taking and clinical
documentation protocol, Infection control policies and procedures
1. Purpose of this document
1.1 This clinical protocol provides a clear framework for nurses employed by Torbay
Care Trust when providing care to patients presenting at MIU with a foreign body in
the nose
1.2 The minor injury Nurse/Community Nurses may assess, treat and discharge
patients presenting with a foreign body in the nose that are not excluded from this
protocol.

2. Exclusions
2.1. The diagnosis of a foreign body is dependent on direct visualisation. If you
cannot view the foreign body the patient must be referred to A+E and the
ENT team
2.2. Where the patient is a child or adult who is un co- operative refer to A+E
ENT team
2.3. Other contraindications to attempting to remove visualised foreign bodies
includes:

Uncharacteristic or excessive pain

Respiratory difficulty

Excessive bleeding from the nose

History of trauma

Last Review Date: June 2009
Version: 1

Page 1 of 5

5.1. Assessment 3. Last Review Date: June 2009 Version: 1 Page 2 of 5 . The MIU nurse should be ware of and use infection control standard Precautions. 4. when attending the patient.1 In accordance with TCT History taking and clinical documentation protocol and NMC guidelines of records and record management (2008).4. The foreign body should be carefully inspected to make sure it is intact .1. 4. Inform patient of the role of Minor injury nurse and obtain consent for treatment 3. If trained and competent to undertake and if the patient is compliant blow up the opposite nostril as this can expel the foreign body 4.6.2.2. The minor injury nurse can attempt to remove visible foreign bodies from the nose. 3. Use thudicums speculum and a blunt hook.3. providing they can be removed at the first attempt and there are not contraindications as stated in the exclusions section. 4. 3. 4. Use of instruments must be aligned to the decontamination of reuseable medical devices policy .2 A letter of the MIU attendance and the care delivered must also be sent to the General practitioner to ensure the central medical record of the patient is accurate. In children undiagnosed FB in the nose frequently present with an unexplained and offensive rhinitis.Management of foreign bodies in the nose 3. crocodile or fine tooth forceps. Documentation 5. 5. The patient should positioned in a clear bright light 4. The foreign body should be removed with the appropriate forceps.5. Management 4. If the foreign body moves backward away from the forceps STOP and refer to A+E. The MIU nurse should carry out an assessment of the patient following the TCT MIU history taking and clinical documentation protocol 3.3. 5.4. If you are concerned that some of the foreign body remains in the nostril refer to A+E ENT team.

6. References: Plymouth Teaching Primary Care Trust minor Injury Unit Handbook of Clinical Protocols Version 2 Amendment History Issue Status Last Review Date: June 2009 Version: 1 Date Reason for Change Authorised Page 3 of 5 .2 The patient and /or carer demonstrates understanding of advice given during consultation 6.4 The patient/carer demonstrates an understanding of how to manage subsequent problems 7.Management of foreign bodies in the nose 5. A copy will be sent to the General practitioner in the normal manner 5. A copy will be sent to the General practitioner in the normal manner 6 discharge information 6.1 The patient /carer understand that if they have any further concerns to seek medical advice.3 For patients being transferred to A+E. ensure a copy of the clinical treatment record is sent with the patient.4 For patients seeing the General practitioner within the next 24 hours ensure the patient has a copy of the treatment record to take with them.3 The patient/carer has been provided with written advice leaflet to reinforce advice given during consultation 6.

Have received training and are competent to operate under this clinical guideline NAME ( Please print) PROFESSIONAL TITLE SIGNATURE AUTHORISING MANAGER ( Please print) Last Review Date: June 2009 Version: 1 Page 4 of 5 DATE . being employees of Torbay Care Trust and based at …………………………….Management of foreign bodies in the nose CLINICAL PROTOCOL FOR THE MANAGEMENT FOR THE REMOVAL OF FOREGIN BODIES FROM THE NOSE The registered health professionals named below.

Management of foreign bodies in the nose Last Review Date: June 2009 Version: 1 Page 5 of 5 .