Publication:

A modified bag-valve-mask positive-pressure technique for removal of nasal foreign bodies in young children: a retrospective study from a rural pediatric practice

Background Nasal foreign bodies are common in young children, and their removal can be difficult because of fear, distress, and poor cooperation. Positive-pressure techniques provide a non-instrumental alternative, but conventional approaches may require direct mouth-to-mouth contact.

Methods This retrospective, single-center chart review included 28 consecutive children aged 1-5 years with clinically diagnosed, anteriorly located nasal foreign bodies treated at a rural pediatric outpatient and emergency setting. A modified bag-valve-mask (BVM) technique was used to deliver a brief, controlled positive-pressure puff through the mouth while the contralateral nostril was occluded. Children were observed for at least 30 minutes.

Results Successful removal was achieved in 26 of 28 children (92.9%; 95% CI=77.4-98.0%). Among successful cases, 22 of 26 (84.6%; 95% CI=66.5-93.9%) were successful on the first attempt. No major complications were recorded during the procedure or observation period.

Conclusions In this single-operator, single-center pilot series, the modified BVM technique achieved a high removal rate for anteriorly located nasal foreign bodies using equipment commonly available in rural clinical settings. Larger, multicenter comparative studies with standardized pressure protocols are required before broader clinical adoption.