# Emergency Management of Pediatric Orbital Pencil Trauma Outside the Operating Room: A Case Report

## TL;DR

A three-year-old girl with a pencil injury to her eye was treated successfully outside the operating room using safe anesthesia protocols.

## Contribution

Demonstrates the safe application of non-operating room anesthesia protocols in managing pediatric orbital trauma emergencies.

## Key findings

- A foreign body was successfully removed under general anesthesia in a minor procedure room.
- NORA safety protocols enabled timely and safe treatment in a non-traditional setting.
- Interdisciplinary coordination and preoperative assessment were critical for successful management.

## Abstract

Penetrating orbital injuries in pediatric patients are rare but potentially vision- and life-threatening emergencies. We present the case of a three-year-old girl who arrived at the emergency department with a penetrating orbital pencil injury. The foreign body was successfully removed under general anesthesia in a minor procedure room, following established non-operating room anesthesia (NORA) safety protocols. This case highlights the critical importance of rapid interdisciplinary coordination, meticulous preoperative assessment, and safe anesthetic conduct in non-traditional environments. Implementation of NORA principles in emergency trauma care can ensure timely intervention while maintaining perioperative safety standards in resource-limited or high-demand settings.