Consumer Trends in Pediatric Nasal Foreign Bodies: A 20-Year National Review of Emergency Department Visits

Introduction: 1) To estimate the incidence of emergency department (ED) visits for pediatric nasal foreign bodies (pNFB) and 2) to identify the most common items involved.

Methods: The Nationwide Electronic Injury Surveillance System (NEISS) was queried from 2004-2023 for ED visits involving the diagnosis of nasal foreign bodies in children under 18 years of age. Data were extracted for case demographics and case variables (e.g. injury setting, disposition, product information). NEISS supplied weights and variance variables to generate national estimates.

Results: There were a total of 690,196 (95% CI: 546,245-834,146) cases of reported ED-treated pNFB from 2004-2023. Mean age was 3.2 + 2.1 years, and 57.4% of patients were female. Jewelry comprised the majority of pNFB cases presenting to the ED (52.3%), followed distantly by paper products (11.2%), desk supplies and stationary (8.1%), and unspecified toys (8.0%). Among toys, building set pieces were the most common, comprising 6.7% of pNFB seen in the ED. Batteries made up about 1.5% of reported ED-treated pNFB. The vast majority (96.2%) of cases were treated and released from the ED, although 0.7% required either admission or transfer for treatment, and 3.0% of cases ultimately left before being seen. Patients who presented with a battery (odds ratio 18.44, 95% CI 7.73-43.98) or coin (OR 6.55, 95% CI 1.89-22.69) were significantly more likely to be admitted or transferred for management (both p < 0.05).

Conclusions: NFB are a common reason for pediatric ED visits, and common items include jewelry, paper products, desk supplies, and toys. This information may guide parental counseling, especially those with children under 5 years old, in order to reduce the risk of this common ED presentation.