Trick of the Trade: A mini-suction device

You are doing a shift in the pediatric ED and you are evaluating a kid with a small bead in her ear. There are a ton different approaches you can use (eg. tissue adhesive glue on a q-tip stick). If the bead is in too deep, blindly trying to adhere the foreign body to the glue is a bit risky. Sometimes applying gentle irrigation might not be enough to wash out the bead. You want to avoid irrigation if you worry about a tympanic membrane rupture.

Trick of the Trade: 
Build a mini-suction device using part of a butterfly needle.

• Cut off the back end of a butterfly needle, leaving about a 2-4 cm tail off of the white plastic hub.
• Tightly wedge the hub into a suction hose.
• Turn on the suction.

Thanks to Dr. Liz Brown (UCSF-SFGH EM resident) for this fantastic idea.