Nkoekoemmoa a Wɔte Ase wɔ Aso Nsu mu ne Ahɔho Nneɛma a Ɛwɔ Hwene anaa Aso mu¶

Nkoekoemmoa a wɔte ase a wɔrewea, wɔrebɔ gyegyeegye, anaasɛ wɔretwe wɔn ho tẽẽ wɔ aso mu, anaasɛ nhwiren, bankye, agode fã, magnet, anaa button battery a wɔpia abofra hwene anaa aso mu kwan no kɔ soro no hwehwɛ nipadua ho nimdeɛ pɔtee ma enti ogyefo rendan akwanside ketewaa bi nkɔ oprehyɛn mu asiane. Esiane sɛ nnompe a ɛwɔ onipa aso mu fã a ɛwɔ mu no yɛ honam ani hwɛbea a ɛyɛ tratraa te sɛ krataa a ɛbata dompe ho tẽẽ a srade nni mu, na esiane sɛ ɔkraman anaa ntontom nan a ɛyɛ nwene no hwɛ akyi ma enti obetumi anantew kɔ n’anim akɔ aso no mu nkutoo nti, sɛ ɔde tweezers anaa kotoku a wɔde hyɛ aso no mu a, ɛma nkoekoemmoa no de ne nsa bɔ tympanic no mu membrane wɔ ehu mu, anaasɛ ɔde bead kurukuruwa bi twa bony isthmus teateaa no ho tẽẽ fa aso no mu. Nea egye ntɛmpɛ mpo ne sɛ, lithium button battery anaa paired neodymium magnets a ɛwɔ hwene anaa aso mu no ma anyinam ahoɔden anaa nhyɛso krampɔn bi ba nsu a ɛyɛ nsu mu a ɛhye tokuru a ɛtra hɔ daa fa hwene mu ntini anaa aso mu dompe mu wɔ simma 60 kosi 120 mu. Nim a wunim sɛnea wode mineral anaa ngodua ngo bɛmene nkoekoemmoa a wɔte ase dwoodwoo, sɛnea wɔyɛ "Ɛna Afew" (Ɔwofo Afew) a egyina adanse so ma nneɛma a ɛyɛ ahɔho a wɔde wɔn hwene mu a ahobammɔ wom, ne nneɛma a ɛnsɛ sɛ wɔde wɔn nsa ka nsu biako mpo da no gye aso ne anim nhyehyɛe ahorow.

Yɛ eyi mprempren¶

1. Nea edi kan no, hu NEA ɛwɔ aso anaa hwene mu ansa na wode wo nsa aka biribiara anaa woahwie nsu biara agu:
2. Button Battery anaa Paired Magnets (Hwene anaa Aso): Kɔ tẽẽ kɔ Ayaresabea Dwumadibea a Ɛho Hia Ntɛmntɛm MPREMPREN. Fa abofra no sie Nothing by Mouth (NPO) ma woyi no ntɛm, na MMFA nsuo a ɛtɔ, nsuo a wɔde petepete, anaa nsuo biara nhyɛ hwene anaa aso mu.
3. Nkoekoemmoa a wɔte ase wɔ Aso mu (Wɔde gyegyeegye denneennen, wɔtwetwe, ne ɛyaw a emu yɛ den): MMFA mfa tweezers, nsateaa, anaa cotton swab nhyɛ aso no mu. Ma onipa no nyɛ komm, hwɛ sɛ onni aso mu ntini anaa aso mu ntini a wonim sɛ wɔato mu, na ma nkoekoemmoa no ntumi nkɔ baabiara/mene no ntɛm ara denam mineral oil a ɛyɛ dan mu hyew anaa ɛyɛ hyew kakra, nkokoaa ngo, anaa ngodua/nnuaba ngo a wode bɛhyɛ aso no mu ma (hwɛ Anammɔn 3).
4. Dry Vegetable Matter (Dried Bean, Pea, Corn Kernel, Seed, or Popcorn) anaa Expandable Foam/Water Bead in the Ear: MFA nsuo nhohoro anaa fa nsuo gugu so DA. Nsuo ma bankye, aba, ne hydrogel beads a ayow no hohoro denneennen wɔ aso a ɛyɛ nnompe a ɛyɛ den no mu, na ɛto mu na ɛma ɛyɛ severe nhyɛso ɛyaw.
5. Adeɛ a ɛyɛ den a ɛyɛ torotoro wɔ Abofra a ɔyɛ adwuma bom hwene BIARA mu (Plastic Bead, Lego Piece, Pea, Foam, anaa Tissue Paper, ƐNYƐ Battery/Magnet): Yɛ "Ɛna Afew" (Ɔwofoɔ Afew) positive-pressure blow no sɔhwɛ baako a ɛyɛ brɛoo (hwɛ Anammɔn 4).
6. MMFA tweezers, cotton swabs (Q-tips), bobby pins, anaa nsateaa nkɔ aso no mu anaa nkɔ soro hwene no mu mfa nkyere ade kurukuruwa bi da. Sɛ standard flat tweezers twitwa kurukuruwa a ɛyɛ torotoro, ɛyɛ nsu (te sɛ plastic bead, pearl, BB pellet, anaa bean) a, anom no twetwe fi curved surface no so na ɛtow ade no deper, wedging no twa dompe no ho isthmus of the ear canal against the eardrum, anaasɛ wɔpia hwene mu ade bi kɔ akyi kɔ mframa kwan no mu baabi a abofra no betumi ahome (aspirate) akɔ wɔn mframa kwan mu.
7. Sɛnea wobesiw nkoekoemmoa a wɔte ase wɔ aso mu ntɛm ara:
8. Tena ase anaa da onipa no ase a aso a ɛka no no hwɛ UP kɔ ɔdan no atifi.
9. Sɛ aso no mu ntini no nsɛee nkutoo (abakɔsɛm biara nni hɔ a ɛkyerɛ sɛ aso mu tokuru, aso mu ntini, anaasɛ mogya tu fi aso mu): Twe akyi aso no brɛoo kɔ soro ne akyi (wɔ ɔpanyin mu) anaa kɔ akyi tẽẽ na ɛkɔ fam kakra (wɔ abofra a onnii mfe 3 mu) na ama aso no kwan a ɛte sɛ S no ateɛteɛ, na hwie ** mineral oil, akokoaa ngo, a ɛho tew ** anaa ngodua ngo** sian fa asubɔnten no nkyɛn kɔsi sɛ ɛbɛboaboa ano wɔ soro, na wode nkoekoemmoa no ahyɛ nsu ase koraa simma 5 kosi 10 kosi sɛ ne kankyee ne ne gyegyeegye nyinaa begyae.
10. (Hyɛ no nsow: Sɛ nkoekoemmoa no yɛ nkoekoemmoa ketewaa bi a ɔtu phototactic te sɛ nwansena anaa nwansena* na wunnyaa ngo biara da a, dum dan mu akanea nyinaa na hyerɛn kanea a ɛhyerɛn wɔ aso no akyi pɛɛ simma 2 hwɛ sɛ ebia ɔfiri adi kɔ kanea no ho anaa, nhyerɛn kanea biara da wɔ akokɔ anaa nwansena bi so da, a ɛyɛ photophobic na ɛbɛto tokuru akyirikyiri fi hann ho.)*
11. Sɛnea wɔyɛ "Ɛna Afew" (Ɔwofo Afew) ma ade a ɛnyɛ batere a ɛkyekyere hwene tokuru BAKO:
12. Ma ɔwofo a wogye no di no nka nkyerɛ abofra no sɛ wɔrebɛma wɔn "afew kɛse a ɛyɛ serew."
13. Fa ɔwofo no ano a abue no to abofra no ano a abue no so koraa (yɛ nsɔano a emu yɛ den te sɛ ahomegye a wɔde gye nkwa no ara pɛ).
14. Fa nsateaa anaa nsateaa biako di dwuma de mia abofra no hwene a UNBLOCKED (nea emu da hɔ) no mu koraa.
15. Fa mframa tiawa biako a ano yɛ nnam, a ɛyɛ den kɔ abofra no anom (a ɛtra hɔ nnu sekan 1, a ɛdɔɔso ara kwa sɛ wobɛte nka sɛ ɔsɔre tia no bere a abofra no glottis no fi awosu mu to mu na mframa kɔ soro wɔ anom a ɛyɛ mmerɛw no akyi kɔ hwene a asiw no akyi), na tow ade no fi hwene a asiw no mu.
16. Hwɛ sɛ "Unilateral Foul-Smelling Nasal Discharge" wɔ Toddlers mu: Sɛ abofra ketewa anaa abofra ketewa bi nya nsu a ɛyɛ huam, ɛyɛ purulent (yellow/green) anaa mogya-tinged mucus a efi hwene mu tokuru BAKO NKUTOO mu nna anaa adapɛn pii a, fa no sɛ ahɔho a ɛwɔ hwene mu a ahintaw (te sɛ sponge, krataa wad, aduan, anaa button battery) no hyɛ saa hwene no mu kosi sɛ oduruyɛfo bi hwene mu nhwehwɛmu bɛkyerɛ sɛ ɛnte saa.

Emergency triage decision dua: Aso vs. Hwene ahɔho nipadua & nkoekoemmoa a wɔte ase¶

Fa saa ayaresabea nhyehyɛe yi paw ɔkwan pɔtee a ahobammɔ wom a wɔfa so yi fi hɔ na kwati nsu a wɔde gugu nnɔbae so anaa nnwinnade mu mfomso a ɛyɛ hu.

flowchart TD
    Start["Ahɔho Ade anaa Nkoekoemmoa a Wɔte ase<br/>wɔ Aso Nsu anaa Hwene mu"] --> SiteCheck{"So Ade no wɔ<br/>EAR CANAL anaasɛ NOSTRIL no mu?"}

    SiteCheck -->|"ASO AKWANKYERƐ"| EarType{"Ade<br/>Bɛn na Ɛwɔ Aso Nsuo no mu?"}

    EarType -->|"LIVE INSECT<br/>(Ɛyɛ dede, ɛyɛ mmerɛw, ɛyaw a emu yɛ den)"| InsectCheck{"So Ɔyarefo Wɔ Aso Ntini,<br/>Wonim Aso mu Nsuo a Tokuru,<br/>anaasɛ Mogya a Ɛfiri Nsuo Mu?"}
    InsectCheck -->|"YIW (Aso a Wɔato Mu / Nsukorabea) ."| InsectER["KƆ ADWUMA A WƆYƐ NHYEHYƐE NSƐM MPREMPREN:<br/>NHWƐ ngo anaa nsu ngu aso a wɔato mu mu;<br/>Oduruyɛfo de suction/micro-forceps bedi dwuma wɔ otoscopy ase"]
    InsectCheck -->|"DABI (Aso a ɛnyɛ hwee) ."| OilKill["IMMOBILIZE / DROWN NKOKOEƐ ADI KAN:<br/>1. Tilt aso a ɛkaa no UP kɔ ɔdan atifi<br/>2. Fa Mineral Oil, Baby Oil, anaa Olive Oil<br/>3 hyɛ aso no mu ma. Fa kɔ nsu ase simma 5 kosi 10 kosi sɛ kankyee nyinaa begyae<br/>4. Hwɛ oduruyɛfo/ahwɛyiye a egye ntɛmpɛ na wode nsu gugu so anaasɛ woyi mmoawa a wɔawuwu"]

    EarType -->|"BUTTON BATTERY anaa SHARP OBJECT<br/>(Ahwehwɛ, Waya, Cotton Swab Tip) ."| EarUrgent["ADWUMAKUO A ƐFA NTƐMƐ HO NSƐM:<br/>1. MMFA nsuo anaa mfa nsuo nhyɛ Button Battery so DA<br/>2. Battery hyew aso mu dompe & anim ntini wɔ < 2 hrs<br/>3. Fa ɔyarefo NPO sie ma wɔde microscopic yi fi hɔ ntɛm ara"]

    EarType -->|"NNUADEƐ NSƐM / HYDROGEL<br/>(Bean, Pea, Aba, Atoko, Nsuo Bead)"| EarBean["ENT / CLINIC YI YIYE NTAM (NSUO NNI HO):<br/>1. MFA nsuo nhohoro mu DA (ɛhohoro bean denneennen wɔ canal mu)<br/>2. Mfa tweezer nnyigye da; oduruyɛfo de hama a ɛwɔ anim a ɛyɛ pɛ na edi dwuma"]

    EarType -->|"INERT SMOOTH OBJECT<br/>(Plastic Bead, Aboɔden abo, Popa) ."| EarBead["SAME-DAY / NEXT-DAY MEDICAL EXAM:<br/>MFA tweezers nnye (ɔpia kɔ nnompe isthmus no ho);<br/>Oduruyɛfo de suction catheter, cyanoacrylate stick,<br/>right-angle hook, anaa nsu a ɛyɛ hyew a wɔde gugu nnɔbae so yi fi hɔ"]

    SiteCheck -->|"NOSTRIL (Anom Nsuo) ."| NoseType{"Ade<br/>Bɛn na Ɛwɔ Hwene no mu?"}

    NoseType -->|"BUTTON BATTERY anaa PAIRED MAGNETS<br/>(anaasɛ Tuntum/Mogya Nnua + Ɛyaw)"| NoseBattery["Ntɛm ara 60-MIN NHYEHYƐE HO ADWUMAKUO:<br/>1. Septal cartilage perforation ba wɔ nnɔnhwerew 1 kosi 2 mu<br/>2. MFA nkyene a wɔde petepete hwene mu anaa nsu a wɔde gu mu nni dwuma DA<br/>3. Fa abofra NPO sie ma wɔde endoscopic yiyi no ntɛm ara"]

    NoseType -->|"SAFE INERT ANAA ORGANIC OBJECT<br/>(Bead, Pea, Lego, Foam, Paper Wad)<br/>wɔ Abofra a Ɔyɛ Komm, Ɔte N’adwene mu"| MothersKiss["YƐ 'ƐNAA AFE' (ANAA AHWEHWƐM):<br/>1. Abofra a wanyin/ɔpanyin: Sie hwene mu tokuru a emu da hɔ & bɔ hwene denneennen<br/>2. Abofra kumaa: Fa ano hyɛ abofra no ano, fa nsateaa mia CLEAR<br/> hwene mu tow, ma mframa tiawa 1 a ɛyɛ den<br/>3. Sɛ puffs 2 di nkogu a -> Kɔ Urgent Care / ER (Mfa tweezers nni dwuma da) ."]

Ɔfã 1: Nkoekoemmoa a wɔte ase wɔ Aso mu¶

Nea enti a nkoekoemmoa a wɔte ase wɔ aso mu de ɛyaw a emu yɛ den ne ehu ba¶

Onipa akyi aso kwan no yɛ ɔkwan bi a ɛte sɛ S a ɛyɛ anifuraefo a ne tenten bɛyɛ \(2.5\text{ centimeters}\) (\(1\text{ inch}\)) a ɛyɛ teateaa wɔ toa bi a wɔfrɛ no bony isthmus a ɛwɔ aso no anim pɛɛ: 1. The Outer Third (Cartilaginous Canal): Wɔde honam ani a ɛyɛ den, nhwi ntini, ne aso ntini a ɛyɛ den ahyɛ mu ma. 2. The Inner Two-Tirds (Osseous/Bony Canal) ne Tympanic Membrane: Wɔde honam ani a ne kɛse yɛ \(0.2\text{ millimeters}\) pɛ a ɛbata ti nhwi dompe no akyi tẽẽ a srade biara nni honam ani, a Trigeminal Nerve (CN V), Facial Nerve (CN VII), nkorabata na ɛka ho Glossopharyngeal Ntini (CN IX), ne Vagus Ntini (CN X, Arnold ntini). 3. Nea enti a nkoekoemmoa no ntumi nsan n’akyi n’ankasa: Ofie nkoekoemmoa a wɔtaa wea wɔn aso mu anadwo bere a nkurɔfo da fam, nsraban wɔ abɔnten, anaa turo mu, titiriw German akɔre (Blattella germanica), nwansena, aso, nwansena, ntɛtea, ne nwansena, wɔ wɔn ti a ɛyɛ teateaa na tibial spines a ɛkyerɛ akyi wɔ wɔn nan so. Sɛ wɔwea kɔ aso no mu nsuo a ɛreyɛ teateaa no mu pɛ a, wɔ honam fam no, wɔrentumi nsan wɔn ho na sɛ wɔbɔ mmɔden sɛ wɔbɛsan akɔ akyi a, wɔn nan a ɛyɛ nsensanee no kyere nsuo no afasuo no. Bere biara a nkoekoemmoa no bɛbɔ mmɔden sɛ ɔbɛkɔ n’anim no, ne nsateaa no twitwiw tympanic membrane a ɛyɛ mmerɛw yiye no so tẽẽ, na ɛma ɛyɛ dede a ɛte sɛ aprannaa a ɛyɛ asotiw wɔ ɔyarefo no ti mu na ɛkanyan ɛyaw a emu yɛ den ne akisikuru (ɛnam Arnold vagal reflex so).

Mmara #1 a ɛfa nkoekoemmoa a woyi fi hɔ ho: KUM / MMƆ nkoekoemmoa no bere nyinaa ANSA na obi abɔ mmɔden sɛ obeyi no afi hɔ¶

Wɔ ayaresabea dwumadibea ahorow a wɔhwɛ ntɛmpɛ so mpo no, ayaresabea nhwehwɛmu kyerɛ sɛ mmɔden a wɔbɔ sɛ wɔde ntama bɛtwe nkoekoemmoa a wɔte ase a wɔrepere afi aso mu no di nkogu anaasɛ ɛma asubɔnten no mu tetew, mogya tu, na aso mu ntini a ɛpaapae wɔ ɔkwan a ɛkɔ soro so, efisɛ nkoekoemmoa no de ne nan a ɛyɛ nsɔe no hyɛ nnompe kwan no fasu no so na ɛtetew mu asinasin bere a n’anim nsateaa tetew mu aso mu ntini.

Anamɔn biara Home Immobilization Protocol (Bere a Aso no Ntumi Nsɛe): 1. Hwɛ sɛ aso mu ntokuru BIARA nni hɔ: Bisa sɛ onipa no wɔ aso ntini (tympanostomy grommets), tokuru a wonim wɔ aso mu, anaa mogya a ɛretu kɛse/nsu a emu da hɔ a efi aso no mu ba wɔ ahodwiriw akyi anaa. (Sɛ wɔwɔ aso anaa aso mu nhama a ntokuru a, MMFA nsu biara ngu aso no mu; ma ɔyarefo no dwo, fa ntama a ɛyɛ hyew a ɛyɛ nwini fa aso no akyi na ama nnyigyei no ano abrɛ ase, na kɔ adwumayɛbea a wɔhwɛ ntɛmpɛ so no tẽẽ.) 2. Position the patient: Have the person lie down on their side (or sit with their head tilted sideways resting on a pillow) with the affected ear pointing straight UP at the ceiling. 3. Select a safe viscous suffocating liquid: - Best home choices: Mineral oil, unscented baby oil, olive oil, or vegetable/canola oil at room temperature or lukewarm body temperature (never hot.). - Why viscous oil is superior to plain water at home: Insects breathe through tiny holes along the sides of their bodies called spiracles, which are coated in water-repellent (hydrophobic) wax hairs that allow many beetles and cockroaches to survive underwater for 15 to 30 minutes while thrashing violently. Viscous oil (mineral oil or olive oil) immediately coats and plugs the hydrophobic spiracles by capillary action, paralyzing and suffocating the insect within 30 to 120 seconds while floating it gently away from the eardrum. - (Hospital note: In the emergency department, physicians use 2% viscous or aqueous lidocaine or mineral oil, which both numbs the ear canal and paralyzes the cockroach's sodium channels quickly, though mineral oil paralyzes some species even faster without stinging raw skin.) 4. Straighten the ear canal and fill to the brim: - For an adult or child over age 3: Gently grasp the top of the outer ear (pinna) and pull it UPWARD and BACKWARD to straighten the S-curve. - For an infant or toddler under age 3: Gently pull the outer ear STRAIGHT BACKWARD and slightly DOWNWARD. - Slowly pour or dropper the oil down the side wall of the ear canal (allowing trapped air bubbles behind the insect to escape) until the oil pools right at the entrance of the canal. 5. Wait 5 to 10 full minutes: Keep the person lying still with the ear facing up until all scratching, buzzing, and movement have completely ceased for at least 5 minutes. 6. Gently drain the oil and seek medical removal of the dead insect: Have the person tilt their head over a towel with the affected ear facing down. Sometimes a small gnat or ant floats right out with the oil. If the dead insect (or any part of it) remains inside the ear canal, go to an urgent care clinic or emergency department the same day so a clinician can flush or lift out the intact carcass and inspect the eardrum, leaving dead insect parts inside the warm ear canal causes severe bacterial/fungal otitis externa within 24 to 48 hours.

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Part 2: Non-Living Foreign Objects in the Ear Canal¶

Children aged 2 to 8 years commonly push beads, small plastic toy parts, pebbles, popcorn kernels, dried beans, crayon tips, or button batteries into their own or a playmate's ear canal, while adults most commonly break off cotton swab (Q-tip) cotton tips, silicone rubber hearing-aid domes, foam earplug fragments, or wireless earbud silicone tips inside the canal.

The 4 Categories of Ear Foreign Bodies and How Each Must Be Treated¶

Nea Enti a Wɔabara Aso Kanea (Hopi Aso Kanea) Pii¶

Mfa wax "aso kyɛnere" a ɛyɛ tokuru nni dwuma da mfa mmɔ mmɔden sɛ wobɛnom ahɔho ade, nkoekoemmoa, anaa aso mu aduru a wɔde hyɛ mu. Biomedical nhwehwɛmu a wɔahyɛ so ne US Food and Drug Administration (FDA) ne AAO-HNS si so dua sɛ aso kyɛnere ma zero vacuum suction wɔ aso kwan no mu (waxy powder a ɛwɔ kyɛnere a wɔahyew no mu no fi kyɛnere wax no ankasa mu koraa) na ɛtaa tow nsu a ɛrefɔw wax tẽẽ gu aso no so, na ɛyɛ causing ɔhyew mu hyew a emu yɛ den ne aso a ɛyɛ den daa.

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Ɔfa 3: Nneɛma a Ɛyɛ Ahɔho a Ɛwɔ Hwene Mu (Nasal Cavity) .¶

Anatomy of the Nasal Cavity: Nea enti a piapia kɔ soro ne mfomso #1¶

Sɛ awofo fi abɔnten hwɛ abofra hwene a, hwene no akyi kwan no sian kɔ soro kɔ aniwa no so, na ɛma nkurɔfo fa no sɛ hwene kwan no kɔ kɔ soro. - Anatomical Reality: Onipa hwene mu (anom a ɛyɛ den no atifi / ano atifi) no tu mmirika kɔ akyi tẽẽ kɔ soro (\(90\text{ degrees}\) gyina hɔ ma anim) kɔ menewa no akyi (anom anom). - Ɛkame ayɛ sɛ hwene mu ahɔho ɔha biara mu nkyem 90 kɔtra mmeae abien no biako: wɔ hwene no anim fam pɛɛ wɔ turbinate a ɛwɔ fam no ase, anaasɛ mfinimfini turbinate no anim pɛɛ. - Nea enti a asiane a ɛwɔ hɔ sɛ wobɛtow akɔ soro anaasɛ wode tweezers bedi dwuma: Sɛ wobɔ kɔ soro a, ɛtwetwe ntini a ɛyɛ mmerɛw a ɛwɔ anim hwene septum (Kiesselbach's plexus / Little's area), na ɛma ɛyɛ duru hwene mu mogya a ɛba a ɛde ade no sie koraa. Nea enye koraa no, sɛ wopia bead anaa peanut kɔ akyi a, ɛma ɛkɔ fam wɔ anom akyi ano tẽẽ kɔ anom ne ahurututu no mu, na ɛde nkwa to asiane mu denneennen a wɔde menewa amene.

Ntɛmpɛ #1 wɔ Hwene no mu: Button Batteries ne Paired Neodymium Magnets¶

1. Bɔton Batere a Ɛwɔ Hwene Mu (Necrosis wɔ Simma 60 kosi 120 Mu) .¶

Sɛ wɔpia sika ketewa anaa bɔton batere (\(3\text{V}\) lithium anaa \(1.5\text{V}\) dwetɛ-oxide/alkaline batere a efi afiri a wɔde te asɛm, agode ketewaa bi, akontaabu afiri, anaa nnwom nkyia krataa mu) kɔ abofra hwene mu a: - Anom nsuo a ɛyɛ nsuo a nkyene wom no ka batere no afã pa (\(+\)) ne negative (\(-\)) no ano, na ɛwie akyi electrolytic circuit. - Wɔ negative (\(-\)) pole (battery no fã a ɛyɛ tratraa na ɛyɛ teateaa a ɛwɔ cap no) no, nsuo mu electrolysis ma hydroxide ions (\(\text{OH}^-\)) ba, na ɛma sodium hydroxide a ɛyɛ den (caustic lye a \(\text{pH}\) yɛ \(12\text{ kɔsi }13\)). - Liquefaction necrosis ma mucosal lining no tew na edi tẽẽ fa cartilaginous nasal septum mu wɔ **simma 60 kosi 120 mu, na ɛma septal perforation (tokuru a wɔbɔ abɛn wɔ hwene no ntam), saddle-nose collapse of the bridge of the nose, anaasɛ erosion kɔ orbit anaa hard palate no mu. - Kɔkɔbɔ Nsɛnkyerɛnne a Ɛkyerɛ sɛ Anom Button Battery a Wonhu: Anom yaw mpofirim wɔ ɔfã biako, abufuw, a ɛyɛ bruu tuntum, tuntum, anaa rusty mogya-tinged crusting/drainage fi hwene tokuru biako mu, anim a ɛho ahonhon wɔ hwene/aniwa no ho, anaasɛ dade hua. - Mmoa a Edi Kan Mmara: Kɔ Ayaresabea Dwumadibea a Ɛhwɛ Ntɛmntɛm So ntɛm ara. Mfa nkyene a wɔde gu mu, nnuru a wɔde petepete hwene mu, anaa nsu mu da. Ma abofra no sie Nothing by Mouth (NPO).

2. Magnets a Ɛwɔ Ahoɔden Kɛse a Wɔabɔ no Bom Wɔ Anom Septum no Ho¶

Ɛtɔ da bi a mmofra a wɔanyinyin ne wɔn a wonnii mfe aduonu de neodymium rare-earth magnet nketewa abien (anaasɛ magnetic "faux nose rings") gu hwene abien no nyinaa mu ma enti ɛbɔ bom fa mfinimfini anom septum no so. - Magnetic attraction a ano yɛ den no bubu mucosal mogya ntini a ɛyɛ mmerɛw (perichondrium) a ɛma anom septum cartilage no aduan no. - Wɔ ** nnɔnhwerew 2 kosi 6** mu no, ischemic pressure necrosis sɛe septal cartilage no na ɛto tokuru a ɛtra hɔ daa fa septum no mu. - Wɔyi Ntɛmntɛm: Anom magnets a wɔabɔ no mmienu hwehwɛ sɛ wɔyi ntɛmpɛ dwumadibea (mpɛn pii no wɔde nnwinnadeɛ a ɛnyɛ magnetic, plastic shims a ɛyɛ tratraa, anaa abɔnten magnets a ɛne ne ho bɔ abira di dwuma wɔ topical anesthesia/vasoconstriction akyi).

Anamɔn-Anamɔn Akwankyerɛ a Ɛfa "Ɛna Afew" (Ɔwofo Afew) Ɔkwan no ho¶

Wɔ ade a wonim sɛ ahobammɔ wom (te sɛ plastic bead, pea, berry, foam piece, anaa Lego stud, ɛnyɛ button battery, magnet, anaa sharp glass/pin da) a akɔhyɛ **BOFRA a n’adwene mu da hɔ, a n’ani da hɔ a wadi mfe 1 kosi 8 hwene tokuru BAKO mu a, "Ɛna Afew" (Ɔwofo Afew) yɛ nea ɛnyɛ yaw, ɔkwan a ɛnyɛ nea wɔde hyɛ nipadua mu a nnuruyɛ a egye ntɛmpɛ akwankyerɛ ahorow (Cochrane Systematic Review ne mmofra dwumadibea atitiriw a wɔhwɛ mmofra a egye ntɛmpɛ so) foa so a ɛpam ade no yiye wɔ puff a edi kan anaa nea ɛto so abien no so wɔ nsɛm bɛboro ɔha biara mu nkyem 60 mu, na ɛkwati dade nnwinnade a ɛyɛ hu anaa ayaresabea aduru a ɛma obi dwo:

Anamɔn 1: Siesie Abofra no na Ma no Awerɛhyem¶

• Ma abofra no ntra ase gyina hɔ (a ɔde ne ho to n’anim kakra) wɔ ɔwofo a ɔwɔ ne mu ahotoso kɔn mu.
• Kyerɛkyerɛ ɔkwan a wɔfa so yɛ no mu sɛ agoru anaa "nkonyaayi atuu kɛse" sɛnea ɛbɛyɛ a abofra no rensu anaasɛ ɔrenhome denneennen. (Sɛ abofra no anyin na otumi di akwankyerɛ ahorow akyi a, di kan ka kyerɛ no sɛ wɔmfa nsateaa biako mia hwene mu tokuru a emu da hɔ a wɔato mu no kɛkɛ na wɔmfa wɔn hwene mmɔ wɔn hwene denneennen fa hwene a asiw no mu a wɔn ano ato mu, ɛno nkutoo na ɛtaa popa ade no fi adi pɛɛ.)

Anamɔn 2: Ka ano na To Hwene a Ɛda Hɔ no mu¶

• Ɔwofo no de wɔn ano a wɔabue no si abofra no ano a abue no so denneennen, na ɛma nsɔano a mframa ntumi nkɔ mu koraa twa abofra no anofafa ho hyia (a ɛte sɛ nea wɔde ahome a wɔde gye nkwa a efi ano kɔ ano ma no yɛ pɛ).
• Ɔwofo no de ne nsateaa kɛse anaa ne nsateaa biako mia abofra no hwene tokuru a WƆNNSIW (a hwee nni mu) no nkyɛnkyɛn koraa wɔ hwene no ho de to mu, na ɛma hwene tokuru a asiw no no bue kɛse.

Anamɔn 3: Fa Mframa Tiatiaa a Ɛyɛ Nnam Baako Ma¶

• Bere a ɔwofo no fi ase bɔ brɛoo no, abofra no abɔde mu anom ntini no to wɔn glottis (nne nhama) mu de bɔ ahurututu no ho ban, na ɛde mframa a ɛbɔ no kɔ soro wɔ anom a ɛyɛ mmerɛw no akyi kɔ anom na ɛkɔ n’anim tẽẽ fa hwene kwan a asiw akyi ade no mu.
• Bere a ɔwofo no te saa ɔsɔretia ketewaa no nka wɔ abofra no anom no, wɔde mframa tiawa biako a ano yɛ nnam, na ɛyɛ den (ɛkɔ so bɛyɛ sikɔne 0.5, mma mframa ntra so te sɛ ahurututu mu home a emu dɔ).
• Mframa a ɛyɛ papa no ma nhwiren anaa pea no fi hwene a asiw no anim tẽẽ kɔ ɔwofo no anim anaa mpopaho so.

Anamɔn 4: Hu Bere a Ɛsɛ sɛ Gyae ("Mmɔden Abien Anohyeto") .¶

• Sɛ ade no amfi adi (anaasɛ ankɔ anim rim no ankasa baabi a ɛhwe ase) wɔ 2 brɛoo puffs akyi a, GYINA ntɛm ara na fa abofra no kɔ ayaresabea a wɔhwɛ mmofra a egye ntɛmpɛ anaa dwumadibea a wɔhwɛ ntɛmpɛ so.
• Dɛn nti na Ɛna Afew no wɔ asiane a ɛkame ayɛ sɛ ɛyɛ zero sɛ ɛbɛpia ade no akɔ ahurututu no mu? Esiane sɛ mframa nhyɛso pa no fi ano kɔ soro na ɛkɔ anim fi hwene no mu nti, mframa a ɛsen no vector no pia ade no fi mframa kwan no so, na ɛnyɛ n’akyi.

Sɛnea wobehu "Wo werɛ Fi" Anom anaa Aso Ahɔho Nipadua Nna Akyi¶

Mmofra nkumaa a wɔadi fi mfe 1 kosi 4 taa pia aduan, sponge, tissue paper, crayon, anaa bead bi kɔ wɔn hwene anaa aso mu a wɔnka nkyerɛ obiara. Hwɛ saa nsaano nkyerɛwee a ɛkyɛ a wɔde hwehwɛ yare yi:

Nkitahodi nkyerɛwee pɔtee ma 911 / 112 / 999 ne ayaresabea triage¶

Fa ayaresabea ho nkyerɛwee a emu da hɔ yi di dwuma bere a woredu dwumadibea a wɔhwɛ ntɛmpɛ so anaasɛ worefrɛ sɛ wɔmmoa wo no:

• Sɛ wosusuw sɛ Button Battery wɔ Hwene anaa Aso mu (Ntɛm ara Ntɛmntɛm):

  *"Emergency triage: me ba a wadi mfe [Age] de BUTTON BATTERY a wosusuw sɛ ɛyɛ [benkum/nifa hwene / aso kwan] no mu bɛyɛ [Number] simma a atwam ni [anaasɛ ɔwɔ acute dark bloody crusting fi hwene tokuru biako mu a battery ayera afi agode bi mu]. YɛMMFA nkyene a wɔde petepete anaa nsu a ɛtɔ gu fam biara nni dwuma na yɛakora abofra no Nothing by Mouth (NPO)।

• Sɛ wopɛ nkoekoemmoa a wɔte ase wɔ Aso mu:

  "Ɔyarefo no wɔ nkoekoemmoa bi a wɔte ase a wɔakyere wɔn wɔ [benkum/nifa] aso no mu tɔnn a ɛde ɛyaw kɛse ba aso no mu. Esiane sɛ ɔyarefo no wɔ [aso mu ntini a enni dɛm nti, yɛde mineral/ngodua ngo yɛɛ nkoekoemmoa no a entumi nkɔ baabiara / abakɔsɛm a ɛfa aso mu ntini a wɔato mu ho, yɛamfa nsu biara anhyɛ mu], na yehia otoscopic extraction ne eardrum inspection ntɛm ara."

• Sɛ wopɛ Organic Bean/Seed anaa Deep Bead wɔ Aso anaa Hwene mu a:

  "Me [Mfeɛ]-afe ba no wɔ [dried bean / water bead / plastic bead] a akɔhyɛ [benkum/nifa aso kwan / hwene mu]. YɛMMFA tweezers ntutu no na YƐMMA nsuo ngugu bankye no so. Yehia otoscopic/nasal extraction denam right-angle hook anaa suction catheter a yɛde di dwuma so."

Nsɛm a wɔtaa bisa¶

Dɛn nti na sɛ wohwie mineral oil anaa ngodua ngo gu aso mu a, ɛma nkoekoemmoa a wɔte ase gyae ntɛmntɛm sen nsu, na bere bɛn na ɛnsɛ sɛ wode ngo di dwuma?¶

Nkoekoemmoa nam ntini nketenkete a ɛwɔ wɔn nipadua mu a wɔfrɛ no spiracles a nhwi a ɛmma nsu ntumi nkɔ mu ayɛ mu ma mu home, na ɛma nkoekoemmoa ne nwansena tumi tra nsu ase simma pii bere a wɔrebɔ w’aso mu ntini no. Ngodua ngo a ɛyɛ nnam, nkokoaa ngo, anaa ngodua ngo kata saa ntini a ɛhome a nsu nnim no so ntɛm ara na esiw ano, na ɛma nkoekoemmoa no amene na ɛyɛ obubuafo wɔ simma 1 kosi 2 mu; nanso, ɛnsɛ sɛ wohwie ngo anaa nsu biara gu aso no mu da sɛ onipa no wɔ aso mu nhama anaa tokuru (tokuru) bi a wonim wɔ n’aso mu, anaasɛ sɛ ade no nyɛ nkoekoemmoa a.

Dɛn nti na asiane wom saa sɛ wode ofie tweezer anaa kotoku bedi dwuma de abɔ mmɔden sɛ wobɛtwe nhwiren anaa abotan bi afi abofra aso anaa ne hwene mu?¶

Onipa aso kwan no teateaa ma ɛbɛyɛ nnompe a ɛyɛ toa (isthmus) a ɛwɔ aso a ɛyɛ mmerɛw no anim pɛɛ, na tweezers a ɛyɛ tratraa a wɔtaa de di dwuma no ntumi mmue ntrɛw wɔ saa ɔkwan teateaa no mu sɛnea ɛbɛyɛ a ebedu nhwiren kurukuruwa bi akyi. Sɛ tweezer a ɛyɛ tratraa twitwiw nhwiren anaa bankye anim a ɛyɛ kurukuruwa a ɛyɛ hwerɛma no a, ɛyɛ adwuma te sɛ ahama na ɛtow ade no kɔ akyiri fa nnompe a ɛwɔ toa no mu no ho kɔ aso no mu tẽẽ, anaasɛ ɛpia hwene mu ahama bi kɔ akyi fa anom kɔ abofra no mframa mu.

Dɛn nti na ɛnsɛ sɛ wohohoro nsu gu aso a bankye a ayow, pea, popcorn aba, anaa nsu bead wom mu DA?¶

Nnuadewa a ayow ( bankye, peas, atoko aba, aba) ne hydrogel nsu nhwiren a wɔayɛ no yɛ nsu a ɛtwetwe nsu, a ɛkyerɛ sɛ ɛtwetwe nsu ntɛmntɛm na ɛtrɛw kɔ ne kɛse a ɛyɛ nwunu mmɔho pii. Esiane sɛ wɔde ti nhwi dompe a ɛyɛ den a entumi ntrɛw akata aso no mu nkyem abiɛsa mu abien so nti, sɛ wɔhohoro nsu gu bankye so a, ɛma ɛhohoro denneennen wɔ nnompe afasu no so wɔ simma kakraa bi mu, na ɛma ɛyɛ yaw a emu yɛ den wɔ nhyɛso mu, honam ani yare, na ɛkame ayɛ sɛ ɛmma wontumi nyi mfi hɔ a wɔnyɛ oprehyɛn.

Ɛbɛyɛ dɛn na batere ketewaa bi a ɛwɔ abofra hwene mu atumi ahye tokuru bi afa wɔn hwene mu wɔ dɔnhwerew 1 pɛ mu sɛ ɛte sɛ nea batere no "awu" mpo a?¶

Batere a "asɛe" a ɛwɔ bɔton mu a entumi mma agode bio mpo da so ara kura ahoɔden a aka (bɛboro volts 1.2) a ɛdɔɔso a ɛbɛma anyinam ahoɔden akɔ bere a anom nsu a ɛyɛ nkyene a ɛyɛ nsu de ne dade a ɛyɛ papa ne nea enye no bom no. Saa anyinam ahoɔden no mu paapae nsu mu nneɛma nketenkete a ɛwɔ batere no negative pole no mu ma ɛyɛ sodium hydroxide (caustic lye) a wɔahyɛ no den, a ɛde nnuru ma hwene mu ntini a ɛwɔ nipadua no mu no tew wɔ simma 60 kosi 120 mu; mfa nkyene petepete hwene mu da, na kɔ baabi a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ ntɛm ara.

Sources a wɔhwɛɛ mu¶

• American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS, United States): Ayaresabea Adwene ne Ayarefo Ahobammɔ Akwankyerɛ a ɛfa Ahɔho Nipadua a Ɛwɔ Aso ne Hwene Mu, Nkoekoemmoa a Wɔte Ase a Wɔmma Wɔnkɔ (Mineral Oil / Lidocaine), ne Button Battery / Paired Magnet Emergencies.
• National Capital Poison Center (United States) ne European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN): Button Battery Ingestion ne Nasal/Otic Impaction Triage ne Management Guidelines (nkyene/nsu a ɛtɔ gu anom anaa otic button battery mu a wɔbara ne \(<2\text{ dɔnhwerew}\) endoscopic yiyi ntɛm ara).
• Cochrane Database of Systematic Reviews and Canadian Medical Association Journal (CMAJ): "Ɛna Afew" (Ɔwofo Afew) Ɔkwan a Wɔfa so Yɛ Anom Ahɔho Nipadua wɔ Mmofra mu: Efficacy ne Safety Meta-Analysis (Cook ne afoforo, CMAJ; \(>60\%\) nkonimdi dodow a enni nsɛmmɔnedi a anibere wom biara).
• Ɔman Akwahosan Dwumadibea (NHS, United Kingdom) ne Royal College of Emergency Medicine (RCEM, United Kingdom): Mmofra Aso ne Anom Ahɔho Nipadua Ayaresa Ho Akwankyerɛ (afã biako a ɛyɛ huam a ɛyɛ fĩ sɛ asuman mu hwene mu ahɔhoyɛ agyiraehyɛde).
• Roberts ne Hedges Ayaresa Nneɛma a Wɔyɛ wɔ Aduruyɛ a Ɛho Hia Ntɛmntɛm Mu: Amannɔne Nipadua a Wɔde Yi Aso ne Anom (Right-Angle Hook, Schuchman Suction, Katz Extractor, Cyanoacrylate, ne Cockroach Immobilization).

Akwankyerɛ ahorow a ɛfa ho¶

• Asotiw a ɛba mpofirim (aso a ɛyɛ mmerɛw) ne aso mu ntini a ɛpaapae a ɛyɛ ahodwiriw mmoa a edi kan
• Mmofra ne nkokoaa CPR ne wɔn a wɔmene wɔn
• Mpataa dompe a wɔamene, akokɔ dompe, ne esophageal aduan impaction
• Hwene mu mogya (epistaxis) mmoa a edi kan
• Mmoa a edi kan a wɔde ma mpanyimfo ne mmofra a wɔde menewa di dwuma