Scenario
A 2 year old child who has inserted a plastic bead into his right nostril is brought to the emergency department by his mother. The child is not distressed. Part of the bead is visualised high up in the nostril.
Question
Discuss the different treatment options (100%)
Answer
FACEM SAQ Exam 2010.2 – Question 5
- The overall pass rate for this question was 61/92 (66.3%)
- Pass Criteria
- Recognition that the presentation is non life threatening
- Discussion –pros & cons of at least 3 methods – for example positive pressure method, suction, alligator forceps, aural hook, glue on a stick
- That an adjuvant to removal of nasal FB maybe required – i.e. procedural sedation – however no specifics of particular agents or detail about this required to pass
- Features of unsuccessful answers
- Direct referral to ENT for inpatient management without some further discussion on possible techniques/methods utilised in the ED
- Going straight to procedural sedation or mentioning propofol alone as sedating/anaesthetic agent
ACEM Fellowship Short Answer Questions (SAQ)
About Mike Cadogan
