When obtaining a history, interact with the child in a nonjudgmental manner. Many children are hesitant to admit placing a foreign body in their nose for fear they will elicit displeasure from their parents or the physician. In 73 percent of cases, the insertion of the foreign body is actually observed by the caregiver or the child reported the presence of a foreign body.8 The treating physician should suspect a nasal foreign body in a child who presents with any of the following:
• Sensation of unilateral nasal obstruction
• Persistent, foul-smelling rhinorrhea despite proper antibiotic treatment
• Persistent unilateral epistaxis
In addition to a nasal examination, a complete head and neck physical exam should also be performed. The ears should be carefully checked for foreign bodies, and the lungs auscultated for wheezing.
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