I just submitted my quarterly column installment on Tricks of the Trade in ACEP News on ENT dilemmas. Kids (and adults) get the most bizarre things in their ears and noses. I’ve seen a cockroach and Q-tips in the ear, and peas and pebbles in the nose. What have you seen, and what are your tricks for getting these things out?

A tool that is sometimes helpful for foreign body extraction is an ENT right-angle Day hook. In a resource limited ED, however, one can be fashioned using a paperclip, hemostat, and pen. Bend the paperclip tip to the shape of right-angle hook using a hemostat and secure onto a pen end, which serves as a handle. This hook can be gently inserted into the nose or ear and slid past the partially obstructing foreign body. By first rotating the instrument 90 degrees, pull the object out using the hook.

A general tip for removing foreign bodies is to use adequate hands-free lighting. Standard room lighting is inadequate. A directed beam of light can be attained using an ENT headgear light or alternatively a camping LED headlamp. You look a little geeky, but it’s worth it.


Michelle Lin, MD
ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
Michelle Lin, MD


Professor of Emerg Med at UCSF-Zuckerberg SF General. ALiEM Founder @aliemteam #PostitPearls at https://t.co/50EapJORCa Bio: https://t.co/7v7cgJqNEn
Michelle Lin, MD