UMEM Educational Pearls

Category: Pediatrics

Title: Magnets in noses...

Keywords: Magnet, Foreign body, pediatric, nose, nasal, perforation (PubMed Search)

Posted: 6/10/2011 by Adam Friedlander, MD (Emailed: 6/11/2011) (Updated: 6/11/2011)
Click here to contact Adam Friedlander, MD

If there is a single truth of pediatric emergency medicine, it is that kids love to stuff things into their noses.  A particular danger (aside from batteries, covered in a previous pearl) is the magnet.  

Specifically, two magnets (as seen with magnet ear and nose rings, frequently worn by children and teens whose pesky parents won't allow piercings), attracted across the nasal septum can cause necrosis and perforation within hours.

Here's how to save yourself (and some noses):

  1.  Place a strong magnet such a mechanic's pocket magnet (<$10), or a pacer inhibition magnet within 1.5cm of the magnets.  Be careful not to apply pressure to the septum.
  2. Watch for the opposite side magnet to fall out of the nose.
  3. Easily remove the second magnet, which is no longer stuck to anything...you can use the strong magnet from step 1 at the nare opening to assist.
  4. Though this method is generally non-traumatic, you should pre-treat the nares with 4% lidocaine and 1:1,000 epinephrine spray to minimize potential bleeding.

References

  1. McCormick SR, Brennan PO, Yassa JG. Magnets and children - an attractive combination? BMJ. 2000;321:514.
  2. Starke L. Easy Removal of Nasal Magnets. Pediatric Emergency Care. 2005; 21:598-599.