Esophageal coin removal by emergency physicians: a continuous quality improvement project incorporating rapid sequence intubation

Author:

Bhargava Rishi,Brown Lance

Abstract

ABSTRACTObjective:The objective of this study was to describe our experience removing esophageal coins from children in a tertiary care pediatric emergency department over a 4-year period.Methods:We retrospectively reviewed a continuous quality improvement data set spanning October 1, 2004, through September 30, 2008.Results:In 96 of 101 cases (95%), emergency physicians successfully retrieved the coin. The median age of the children was 19 months (interquartile range [IQR] 13–43 months; range 4 months–12.8 years). The median time to removal of coin from initiation of intubation was 8 minutes (IQR 4–14 minutes; range 1–60 minutes). Coins were extracted using forceps only in 56 cases, whereas forceps and a Foley catheter were used in the remainder. Succinylcholine and etomidate were used in almost all cases for rapid sequence intubation prior to coin removal. Complications were identified in 46 cases: minor bleeding (13), lip laceration (7), multiple attempts (5), hypoxia (3), accidental extubation (3), dental injuries (3), bradycardia (2), coin advanced (1), right main-stem bronchus intubation (1), and other (8).Conclusions:Emergency physicians successfully removed esophageal coins following rapid sequence intubation in most cases. Our approach may be considered for the management of pediatric esophageal coins, particularly in an academic pediatric emergency department.

Publisher

Springer Science and Business Media LLC

Subject

Emergency Medicine

Cited by 7 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. The role of point‐of‐care ultrasonography in esophageal foreign body removal;Pediatrics International;2023-01

2. Esophageal Foreign Body Removal;Atlas of Emergency Medicine Procedures;2016

3. Diagnosis of Pediatric Foreign Body Ingestion;Annals of Otology, Rhinology & Laryngology;2015-10-16

4. Removal of Blunt Esophageal Foreign Body Using Foley Catheter in Children;Pediatric Emergency Medicine Journal;2015-06-30

5. Clinical effectiveness of bougienage for esophageal coins in a pediatric ED;The American Journal of Emergency Medicine;2014-10

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