Before attempting this technique, ensure that the item being retrieved is a ferromagnetic metal. A great way to verify this is to test a similar item beforehand to ensure that it is attracted to the magnet with adequate force. A quality of ferromagnetic metals is that they can be strengthened by the addition of other magnets in series.

By attaching an even stronger magnet—such as the pacer magnet kept in most EDs—to the handle of the telescoping magnet, you can strengthen the magnetic force at the tip.

The advantages of using a magnet for removal of a foreign body are that this technique is not affected by the shape of the object, and it can be performed with minimal visualization. Furthermore, the risk of pushing the foreign body farther into the nose is minimal.

Once you have made contact with the object (you may or may not be able to feel this), it has become affixed to the magnet and can be pulled out. This technique should not, however, be used with objects with sharp edges that may lacerate the nasal tissues as they are pulled through. If the object being removed becomes lodged, gentle twisting and traction should help dislodge it.

Not all FBs are inserted. Patients can present with FBs that have become circumferentially stuck around fingers and other appendages.

In one case, a patient had decided to place 12 quarter-inch-thick (6 mm) steel rings around the shaft of his penis. We started our attempt to remove the rings by using the standard ring cutter. After only a few minutes, the ring cutter broke while making only a small scratch on the surface of the rings. Steel is much harder than the usual precious metals found in jewelry.

A Dremel tool was considered, but we thought that this might generate too much heat in the rings and adjacent penile tissue. With closer inspection of the rings, it became apparent that the thickness of these rings was about the same as that of a Steiman pin, which is also made of steel.

PITrick of the trade: Many of the medical devices used in orthopedics resemble things you can find at Home Depot. A Steiman pin is traditionally placed through the proximal tibia and cut on both ends with a “bolt” cutter. Although it serves the same function as a nonmedical bolt cutter, this cutter is made of stainless steel.