Trick of the Trade: Pediatric video laryngoscope for ear foreign bodies

Trick of the Trade: Pediatric video laryngoscope for ear foreign bodies

2016-11-11T19:35:39+00:00

tweezerIt is near the end of your shift and one of the nurses asks you to see a fellow ED staff member’s nine-year old daughter who has accidentally put a foreign body into her ear. You go see her and the otoscope reveals a small shiny jewel within the ear canal however flushing does not work to get it out. Next you try using the otoscope, while exposing the ear canal and holding the forceps to grasp the object. Unfortunately, it is difficult to get your assistant to align the light, and the otoscope speculum is limited in view and access.

Trick of the Trade: Pediatric video laryngoscope for better visualization

Using a Miller 0 blade of a pediatric video laryngoscope (in this case we used a C-MAC), you are able to provide exposure to the ear canal and light as well as allow access to remove the object. The jewel is easily removed with forceps.

The same may be done with a regular direct laryngoscope. The advantage of video may be to provide magnification, to supervise learners in the removal of foreign bodies and may assist in visualizing deeper objects within the ear or nasal cavity.

pediatric video laryngoscope

Cmac 2
Cmac 3

Cmac 4

 

Other Tricks of the Trade discussing ear foreign bodies (insect in ear, bead in ear).


Yen Chow, MD CCFP

Yen Chow, MD CCFP

Emergency Physician, Thunder Bay Regional Health Sciences Centre;
Regional Medical Director, Ornge;
Assistant Professor, Emergency Medicine Section, Northern Ontario School of Medicine
  • Paul Dupuis

    nicely done Yen…..if only we had a VL….much less a peds VL!!

    • Yen Chow

      Thanks Paul … I’m working hard on getting us back VL in department! and peds too! DL will work for this particular trick but I find that I might be getting to the point where magnifying loupes would come in handy!

  • Frederic Sarrazin

    Well done Yen!

  • Jon Smart

    Great post, the pictures really help show how well the technique works! What do you think of combining this great way of visualizing the object with the “Derma-Q” retrieval technique described in the PEM ED podcast back in April?

    (Link:http://www.pemed.org/blog/2014/4/9/anyone-seen-my-corn-pediatric-foreign-bodies.html)

    • Yen Chow

      Thanks! That should work well and might allow great exposure and visualization for fine manipulation … just avoid getting any tissue adhesive on your lens or light of the laryngoscope!

  • Marlena

    Nice new trick!

  • Bob P

    I see you are using the CMAC. We’ve been using their digital flexible scopes for ear and airway foreign bodies (sensations). It’s been great and very versatile.