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I have been using the following technique over the last 8 years with very good success.  Has worked with beads, peanuts, rocks and crayons etc. that have been placed in the nose.

It is known here as the "Beamsley Blaster" Technique.
 

• Let oxygen connecting tubing and attach tubing connector (looks like christmas tree on both sides) and place into oxygen tubing.
• 

• Lay child on their side with foreign body side down.   Make sure other side unobstructed.

• Place a drop of neosynephrine nasal spray into affected side.

• Hold child securely with one person keeping control of the head.

• Turn oxygen flow meter up to 15 lpm or slightly higher if needed.
•  

• Very carefully with plastic connector tilted up,  place quickly in nostril that does not have the foreign body making sure no air flow goes in obstructed side.

• Usually within several seconds the offending object blasts out of the other nostril. (Don't stand in the line of fire.)
• I think the startle of air blast causes child to temporarily close  soft palate and that promotes air flow out of opposite nostril to blast out object.

• I always recheck the nose and TM's but never a problem.
• 

Parents and staff are usually quite impressed and amused with the procedure as was my son posing for the pictures.

We recently published an article in The American Journal of Emergency Medicine (Am J Emerg Med 2002;20:103-104) "Nasal Positive-Pressure Technique for Nasal Foreign Body Removal in Children" Describing this technique.

Alan C. Beamsley, D.O.

Am J Emerg Med 2002 Mar;20(2):103-104 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11880873&dopt=Abstract

Nasal positive-pressure technique for nasal foreign body removal in children.

Navitsky RC, Beamsley A, McLaughlin S.

Department of Emergency Medicine, Providence Health System, Anchorage, AK, USA.

Nasal foreign bodies in children are often encountered in emergency medicine and many methods of removal exist. This study examines the nasal positive pressure technique, a method not previously described in the literature. A retrospective chart review of nasal foreign body removal using the nasal positive pressure technique was conducted, as well as, a follow-up telephone survey of patient's parents. Nine patients were identified over a 1-year period. The average time from triage to discharge was 34 minutes (15-106 minutes). No sedation, consultation or complications were recorded. Five of the 9 parents completed the survey. All 5 (100%) described the procedure less traumatic than an injection, and 4 (80%) described the procedure similar or less traumatic than an oral pharyngeal exam with a tongue depressor. Nasal positive pressure technique for nasal foreign body removal is a safe and efficient method, and it is relatively nontraumatic in the view of parents. Copyright 2002, Elsevier Science (USA). All rights reserved.)

PMID: 11880873 [PubMed - indexed for MEDLINE]