• Alligator forceps.
• Simple forceps.
• Ear curette (metal or plastic).
• Right-angle hook.
• Irrigation setup (water pik device or 20–60-mL syringe attached to cut-off butterfly tubing or angiocatheter).
• Otoscope with operating head.
• Lidocaine spray or viscous lidocaine suspension.
• Frazier tip or Schuknecht suction.
• Cyanoacrylate glue adhesive.
• If the child cannot be adequately restrained, do not attempt removal.
• Most foreign bodies do not require urgent removal, and the child can be referred to an otolaryngologist if efforts fail.
• Never use irrigation to remove disc batteries, vegetable matter, or expansible objects (eg, sponge).
• Hard spherical objects can be difficult to remove. Do not use forceps because they may push the object further into the canal.
• Sharp objects pose a higher risk of tympanic membrane perforation. Proceed with caution or refer to an otolaryngologist for removal with an operating microscope.
• The first attempt is the best attempt. Repeated attempts with a struggling child are not likely to be successful.
• Test for and document any dizziness or hearing loss before removal attempts. Document an additional examination after the foreign body has been removed.
