Foreign Body Ingestion Clinical Pathway — Emergency Department, ICU, and Inpatient

Clinical Pathways Home Emergency ICU Inpatient Outpatient Specialty Care Primary Care

Goals and Metrics

Patient Education

Related Pathway

Behavioral Health Issues, ED

Triage Imaging
- Two view chest X-ray
Additional Imaging
- Neck, abdomen as indicated
- Lateral if:
  - Battery/magnet/coin supsected
  - Esophageal location
  - FB location uncertain

Suspected Foreign Body (FB) Ingestion

Button Battery Referral to CHOP PHL

Child with confirmed esophageal, nasal or airway button battery
Activate Button Battery Notification
- Notifies: ENT, GI, Gen Surg, OR
- Child goes directly to OR
Pre-hospital Recommendations
Antibiotic Prophylaxis
- Consider for severe esophageal injury, perforation, fever
Cross-sectional imaging per
ENT/GI Consult

Triage, Imaging

Resuscitation Room
Impending/existing
respiratory or
circulatory failure

Suspected ingested
or nasal button battery
Notify PEM and expedite X-ray

FLOC/RN Team Assessment
History and Physical, Imaging

Button Batteries

Confirmed Esophageal Button Battery
Activate Button Battery Notification
Emergent endoscopic removal
OR Board Runner 5-4444

Button Battery Ingestion Triage and Treatment Guideline
National Capital Poison Center
4-2100 or 800-222-1222
National Battery Ingestion Hotline:
800-498-8666

Magnets

Sharp Objects

Posted: July 2013
Revised: September 2023

Authors:

Editors: Clinical Pathways Team

Evidence

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.

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Emergency Department Clinical Pathway for the
Evaluation/Treatment of Children with Foreign Body Ingestion

Evidence

Emergency Department Clinical Pathway for theEvaluation/Treatment of Children with Foreign Body Ingestion

Evidence

Emergency Department Clinical Pathway for the
Evaluation/Treatment of Children with Foreign Body Ingestion