FOREIGN

BODY
CHILD HEALTH NURSING

PREPARED BY,
JOMOLABRAHAM
2018-2022
 INTRODUCTION:

 Children Are prone to injury from foreign bodies ,

because of their curiosity and desire too taste and
manipulate objects and toys .

 Children may either aspirate any foreign body or insert it

into body orifice .
 FOREIGN BODY:

 An object or piece of extraneous matter that has

entered the body by accident or design.
 1. FOREIGN BODY ASPIRATION :

 It is condition occurs ,when any solids or liquid

substances is inhaled into the respiratory tract and

results in airway obstruction and hypoxia”

1. FOREIGN BODY ASPIRATION :

 Usually seen in children <5 years age

Commonly aspirated foreign bodies :

 Foods

 Coins

 Toys

 Marbles, beads

 Buttons

 seeds
ETIOLOGY :

 Child’s curiosity
 Lack of supervision
 Desire to explore objects
 Provoke him to put the objects into the mouth ,so
as to taste it
 Not developmentally prepared to ingest
PATHOPHYSIOLOGY:

 Aspirated foreign bodies pass through the larynx,

trachea to become lodged in the bronchi
 Obstruction of the right main bronchus
 Obstruction may be partial or complete .
 Complete airway obstruction usually occurs in the
upper airway and immediate threat to life
CLINICAL MANIFESTATIONS:

FEATURES OF FOREIGN BODY IN LARYNX :

 IMMEDIATE HOARSENESS
 STRIDOR
 APHONIA
 DYSPNEA
 WHEEZING
 CYANOSIS
CLINICAL MANIFESTATIONS:

FEATURES OF FOREIGN BODY IN TRACHEA:

 COUGHING
 ASTHMA
 WHEEZING
 HOARSENESS
 STRIDOR
 DYSPNEA
 CYANOSIS
CLINICAL MANIFESTATIONS:

FEATURES OF FOREIGN BODY IN BRONCHI :

 COUGHING
 WHEEZING(partial obstruction )
 HOARSENESS
 STRIDOR
 No Breath sounds(no air bypasses the obstruction)
CLINICAL MANIFESTATIONS:

Immediate signs and symptoms :

 Sudden violent coughing
 Gagging
 Wheezing
 Vomiting
 Apnea
 cyanosis
CLINICAL MANIFESTATIONS:

After aspirating a foreign object the child may remain

asymptomatic for hours or weeks .

Signs and symptoms of tracheal obstructions :

 Chocking
 Dysphagia
 Croupy cough
 Unilaterally decreased breath sounds
 Pneumonitis
 Respiratory arrest
DIAGNOSTIC EVALUATION

 HISTORY COLLECTION
 PHYSICAL EXAMINATION

LARYNGEAL FOREIGN BODIES:

 X-RAY AND DIRECT LARYNGOSCOPY

TRACHEAL FOREIGN BODIES:

 BRONCHOSCOPY
 CHEST X-RAY
DIAGNOSTIC EVALUATION

 SIGNS AND SYMPTOMS OF ASPIRATION

AND CHOKING
 HISTORY OF CHOKING INCIDENT
 HISTORY OF RECURRENT INTRACTABLE
PNEUMONIA
 CHEST AND SOFT TISSUE RADIOGRAPH
 FLUOROSCOPIC EXAMINATION
 MANAGEMENT:

 If the child is conscious and can breath and

cough ,

 Instructed to cough deeply in an effort to expel

the object .
 MEDICAL MANAGEMENT:

 Endoscopy
 Tracheotomy (severe dyspnea)
 Bronchoscopy
 Thoracotomy(rarely )
 Chest physiotherapy and bronchodilators should
not be given .
 Antibiotics are needed for secondary infections .
 MANAGEMENT of an obstructed
airway :

 Specific emergency care

 Blind fingers sweeps should be avoided
 Manual relief of obstruction is attempted only if
the child’s effort are ineffective or increased signs
of respiratory difficulty occurs.
MANAGEMENT OF OBSTRUCTED
AIRWAY :
 For the infant under 1 year of age –
 Combination of back blows
 chest thrush
 MANAGEMENT of an obstructed
airway :

 For adults and children over 1 year of age –

 Heimlich maneuver
 Transport :

 Transport from facility to another facility

should be planned and co-ordinated by both
teams
Emergency treatment :

1. Infants :
 Straddle infant over the arm and support head by resting
jaw in right hand .
Emergency treatment :

1. Infants :
 Rescuer rest forearm on own thigh
Emergency treatment :

1. Infants :
 Deliver 5 back blows with heel of hands between
infants shoulder blades
Emergency treatment :

1. Infants :
 Turn the infant,
 done by keeping one hand on infront of infants.
 Supporting neck, jaw and chest ,other hand
supporting back.
Emergency treatment :

1. Infants :
 Infant placed on rescuers thigh and with head
lower than trunk
Emergency treatment :

1. Infants :
 Continue too support head and neck ,perform 5 chest
thrust in location ,where external chest compressions are
performed.
Emergency treatment :

2. Child:
 Heimlich maneuver
Emergency treatment :

Heimlich maneuver
 If the person is able to cough forcefully, the person
should keep coughing.
 If the person is choking and can’t talk, cry or laugh
forcefully, the American Red Cross recommends a “five-
and-five” approach to delivering first aid:
Emergency treatment :

 Heimlich maneuver

1. Give 5 back blows. Stand to the side and just behind a

choking adult. For a child, kneel down behind. Place one arm
across the person’s chest for support.

2. Bend the person over at the waist so that the upper body
is parallel with the ground. Deliver five separate back
blows between the person’s shoulder blades with the heel
of your hand.
Emergency treatment :

 Heimlich maneuver

3. Give 5 abdominal thrusts. Perform five abdominal thrusts

(also known as the Heimlich maneuver).

4. Alternate between 5 blows and 5 thrusts until the

blockage is dislodged.
Nurses management :

 Recognize the signs of foreign body aspiration and

implement immediate measure to relieve the
obstruction
 Back blows and Heimlich maneuver
 Recognize signs of distress
 Prevention
 PREVENTION

 Anticipatory guidance

 Avoid letting their child play with toys with small parts and
to keep coins and other small objects out of reach of children

 Teach the parents not to feed peanuts and popcorn to their

children below 3 yrs of age .

 Chop all food items into small pieces

 Harmful liquids should be kept out of reach of children .

1. FOREIGN BODY IN EAR :

 VERY COMMON AND EASY TO DIAGNOSE

Commonly aspirated foreign bodies :

1) LIVING FOREIGN OBJECTS

2) NON-LIVING FOREIGN BODIES

a) 1. NONHYGROSCOPIC FOREIGN BODIES

b) 2. HYGROSCOPIC FROEIGN OBJECTS

DEFINITION:

 A foreign body in the ear is anything that gets

stuck in the ear canal other than earwax.
ETIOLOGY :

NON-LIVING INORGANIC
 SPOONGE  BEADS
 ERASER  METAL
 PAPER  STONES
 WOOD  PLASTIC TOOY
 COOTTON BUDS  BUTTON
LIVING  BATTERY
 BEANS
 NUTS
 WORMS
CLINICAL MANIFESTATIONS
 FEELING OF SOMETHING IN THE EAR
 EAR FULLNESS
 TROUBLE IN HEARING
 ITCHING
 OTALGIA(ACHE)
 FEVER
 REDNESS
 BVVLEDDING
 THICK DRAINAGE
 FOUL ODOUR
 FEEL MOVEMENT OR HEAR BUZZING
DIAGNOSTIC EVALUATION:

 HISTORY COLLECTION

 PHYSICAL EXAMINATION

 OTOSCOPY

 AUDIOMETRY
MEDICAL MANAGEMENT :

DEPEND ON
 THE TYPE
 HOW LONG
 HOW DEEP
MEDICAL MANAGEMENT :
 NUMBING MEDICINE PUT BEFORE TRYING TO REMOVE

 SEDATIVE AGENT

 PAIN MEDICATION

THREE STANDARD METHODS FOR REMOVING FOREIGN BODIES

ARE :

1. IRRIGATION

2. SUCTION

3. INSTRUMENTATION.
 MEDICAL MANAGEMENT :
PROCEDURES:

1.INSTRUMENTS :

 GRASPER FORCEPS

 HOOOKS OR CURETTE (SCRAPPER)

 ALLIGATOR FORCEPS

2.EAR IRRIGATION

 WATER USED TO FORCE THE OBJECT OUT OF THE CANAL

3.SUCTION :

 MACHINE SUCKS OUT THE OBJECT

4.CHEMICALS

 HYDROGEN PEROXIDE OR CAETONE USED TO MELT DRIED GLUE

AND TO REMOVE GUM OR PLASTIC FOAM .
 MEDICAL MANAGEMENT :

PROCEDURES:

5.OTHERS :

 LIQUID SUCH AS- MINERAL OIL(LIVE INSECT )

 SURGICAL MANAGEMENT :

 SURGERY IS DONE , IF THE FOREIGN BODY IS

VERY DEEP.

 SURGERY MAY BE DONE TO TREAT EAR

DAMAGE CAUSED BY THE FOREIGN BODY.
NURSING MANAGEMENT :
 Assess the non-verbal signs of ear pain

 Educate the patient not to put fingers or other objects

into the ear

 Teach the patient how to use topical antibiotics, oral

antibiotics, and other medications to promote healing

 Instruct patient to report any prolonged symptoms of

ear pain, swelling, drainage or plugged feeling.
COMPLICATIONS:

 EAR CANAL ABRASIOONS

 BLEEDING

 INFECTIONS

 PERFORATION OOF THE TYMPANIOC

MEMBRANE

 OTITIS MEDIA

 FOREIGN BOODY GRANULOMA

FOREIGN BODY IN NOSE:

 Children can insert foreign bodies in their nose

 Objects are small beads, nuts , rubber, chalk present.
CLINICAL MANIFESTATION:
 Foul smelling
 Nasal discharge
 Rhinolitis
 Wheezing sound
 Pain in the nose
 Swelling in the nose
 Respiratory obstruction
Management:

 The ear is examined by simply lifting the tip of the nose with
examiners thumb

 Nasal speculum for examining the nasal cavity

 For easily visible objects , non spherical , non friable

objects-direct instrumentation

 Balloon catheter removal

 Occlusive nasal foreign bodies may be removed by positive

pressure technique or under GA