EM · Procedural & diagnostic ED skills

Foreign body removal in the emergency department

Also known as Foreign body removal · Soft tissue foreign body · Corneal foreign body · Aural foreign body · Nasal foreign body · Button battery removal · Rust ring removal · Splinter removal

Foreign body removal in the ED across the four anatomical compartments — the soft tissue FB (the wood splinter, the glass shard, the metal shaving, the needle), the ocular FB (the metallic rust ring, the conjunctival FB under the upper lid), the aural FB (the bead, the live insect, the cotton-bud tip, the button battery), and the nasal FB (where the button battery is a time-critical emergency). The technique spine — local anaesthetic, a sterile field, the right instrument (forceps, hook, needle), and a systematic wound exploration — is shared, but each compartment has its own equipment, its own pitfalls, and its own escalation trigger. The imaging logic is radio-opaque versus radiolucent: an X-ray for the metal and the glass, a high-frequency ultrasound for the wood and the plastic. The post-removal care is tetanus assessment, wound toilet, and antibiotics only for the contaminated, the bite, and the plantar puncture. The differential on every case is retained versus resolved — and the worst error is to discharge a patient with a residual fragment and a developing infection. ACEM-primary, globally tagged.