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elevated Otolaryngology and neurosurgery should be consulted Prophylactic antibiotics are controversial TRAUMA TO THE NOSE AND SINUSES Nasal Foreign Body Goals of Treatment The goal of treatment is to identify a nasal foreign body, to allow prompt removal Safe removal of the foreign body reduces the risk of acute aspiration, subacute local infection, sinusitis, and cartilaginous injury CLINICAL PEARLS AND PITFALLS Unilateral malodorous nasal discharge should raise suspicion for a nasal foreign body Care must be taken to avoid pushing or irrigating the object during examination or removal attempts, as migration to the nasopharynx puts the child at risk for aspiration Pretreatment with vasoconstrictor as well as use of a nasal speculum can improve visualization and facilitate removal A known or suspected disc battery should be removed immediately to avoid caustic injury Current Evidence Foreign bodies can obstruct the nares If the object has been present for an extended duration, granulation tissue can form around the object Either the tissue or the object itself can block the ostia and increase the risk of infection Clinical Considerations Clinical Recognition Witnessed insertion or foul unilateral discharge is key to diagnosing a nasal foreign body Triage Children generally present to triage well appearing with a history consistent with foreign body Rarely, associated injury may result in epistaxis that should be addressed urgently Nasal foreign bodies can migrate posteriorly, changing a