Minerva Pediatrics 2021 Sep 13

DOI: 10.23736/S2724-5276.21.06334-5

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Current management for foreign body and toxic agent ingestion in a paediatric primary emergency centre

Takeshi NINCHOJI ^{1, 2} ✉, Kandai NOZU ¹, Atsushi KONDO ¹, Shinya ISHIKO ^{1, 3}, Ai UNZAKI ³, China NAGANO ¹, Hiroshi YAMAGUCHI ¹, Hiroki TAKEDA ¹, Takuro HAYASHI ⁴, Ryojiro TANAKA ⁴, Hiroaki NAGASE ¹, Kazumoto IIJIMA ¹, Akihito ISHIDA ³

¹ Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan; ² Department of Pediatrics, Steel Memorial Hirohata Hospital, Himeji, Japan; ³ Kobe Children's Primary Emergency Medical Center, Kobe, Japan; ⁴ Department of Emergency and General Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan

OBJECTIVES: Accidental foreign body ingestion (FBI) and toxic agent ingestion (TAI) are commonly encountered among children in primary emergency settings. Early detection and appropriate medical intervention are crucial to improve outcomes. Although many reports from tertiary institutions have shown improvements in therapy, data are still lacking from primary emergency facilities.
METHODS: We performed a retrospective analysis based on medical records of FBI/TAI over 4 years at the Kobe Children’s Primary Emergency Medical Center. We collected patient information, including age, sex, time between FBI/TAI occurrence and centre visit, provision of first aid, symptoms, type of FBI/TAI, examinations, treatments, and outcomes.
RESULTS: A total of 580 children were enrolled. The median age was 1.3 years, and patients under 2 years old accounted for 70% of total cases. Cigarettes (17.5%) were the most common ingested foreign body, followed by medicines (15.3%), detergents (8.1%), in TAI, plastics (14.1%), metal (13.4%), batteries (9.0%) in FBI, and others (22.6%). A total of 42 patients were transferred to advanced hospitals; among these, 22 patients were hospitalised but the foreign body was removed in only 3 (0.9%) patients. Transferred patients were significantly older (P<0.05) in FBI and had a higher rate of any of symptoms (P<0.05) in FBI/TAI.
CONCLUSIONS: This large-scale retrospective study of accidental FBI/TAI conducted at a primary emergency facility clarified current management, including treatment at a primary facility. Very few cases of FBI/TAI were treated, even when they were transferred to an advanced treatment hospital. Unified protocols should be established, to improve the management of FBI/TAI.

KEY WORDS: Foreign body ingestion; Toxic agent ingestion primary emergency centre; Transfer