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Ingestion of metallic foreign bodies: A Paediatric Emergency Research in the United Kingdom and Ireland survey of current practice and hand-held metal detector use

Lafferty, Max; Lyttle, Mark D.; Mullen, Niall; PERUKI

Ingestion of metallic foreign bodies: A Paediatric Emergency Research in the United Kingdom and Ireland survey of current practice and hand-held metal detector use Thumbnail


Authors

Max Lafferty

Niall Mullen

PERUKI



Abstract

Aim: To describe variation in the initial management of children presenting to Emergency Departments (ED) with coins lodged in the oesophagus. To determine the usage of hand-held metal detectors (HHMDs) in EDs, including their role in clinical decision-making, and training in their use. Methods: Online multicentre cross-sectional survey of EDs in the UK and Ireland, with results described using descriptive statistics. Results: Fifty-five (90%) of 61 sites responded. The two main strategies described for lodged oesophageal coins were endoscopic removal or observation with reassessment, dependent on location. For coins in the proximal third of the oesophagus 43/55 (78.2%) referred for endoscopic removal, 6/55 (10.9%) observed and the remaining 10.9% used a variety of methods, including: Foley catheter removal with fluoroscopy, blind Foley catheter removal, referral to paediatric surgery/ENT. Thirty (55%) of 55 used HHMDs, 21/30 (70%) had guidelines for their use, and 3/30 (10%) provided formal training. Twenty (67%) of 30 used the xiphisternum as the anatomical cut-off for assuming safe passage of metallic foreign bodies (FB) beyond the lower oesophageal sphincter. Conclusions: There is considerable variation in the management of oesophageal coins in children, though two dominant strategies were identified. As endoscopy is significantly more invasive than observation, future research should aim to determine whether either is more effective and safer in children. There is a clear division in departmental adoption of HHMDs. However, in those sites using HHMDs there was little formal training in their use, and there are large variations in techniques and their role in clinical decision-making.

Citation

Lafferty, M., Lyttle, M. D., Mullen, N., & PERUKI. (2021). Ingestion of metallic foreign bodies: A Paediatric Emergency Research in the United Kingdom and Ireland survey of current practice and hand-held metal detector use. Journal of Paediatrics and Child Health, 57(6), 867-871. https://doi.org/10.1111/jpc.15343

Journal Article Type Article
Acceptance Date Jan 27, 2021
Online Publication Date Mar 15, 2021
Publication Date Jun 1, 2021
Deposit Date Apr 1, 2021
Publicly Available Date Mar 29, 2024
Journal Journal of Paediatrics and Child Health
Print ISSN 1034-4810
Electronic ISSN 1440-1754
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 57
Issue 6
Pages 867-871
DOI https://doi.org/10.1111/jpc.15343
Keywords Pediatrics, Perinatology, and Child Health
Public URL https://uwe-repository.worktribe.com/output/7243750

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Ingestion of metallic foreign bodies: A Paediatric Emergency Research in the United Kingdom and Ireland survey of current practice and hand‐held metal detector use (52 Kb)
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Copyright Statement
This is the peer reviewed version of the following article: Lafferty, M., Lyttle, M. D., Mullen, N., & PERUKI, . (2021). Ingestion of metallic foreign bodies: A Paediatric Emergency Research in the United Kingdom and Ireland survey of current practice and hand-held metal detector use. Journal of Paediatrics and Child Health, 57(6), 867-871, which has been published in final form at https://doi.org/10.1111/jpc.15343. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions


Ingestion of metallic foreign bodies: A Paediatric Emergency Research in the United Kingdom and Ireland survey of current practice and hand‐held metal detector use (318 Kb)
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http://www.rioxx.net/licenses/all-rights-reserved

Publisher Licence URL
http://www.rioxx.net/licenses/all-rights-reserved

Copyright Statement
This is the peer reviewed version of the following article: Lafferty, M., Lyttle, M. D., Mullen, N., & PERUKI, . (2021). Ingestion of metallic foreign bodies: A Paediatric Emergency Research in the United Kingdom and Ireland survey of current practice and hand-held metal detector use. Journal of Paediatrics and Child Health, 57(6), 867-871, which has been published in final form at https://doi.org/10.1111/jpc.15343. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions




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