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

Clinical Pathways Home Emergency ICU Inpatient Outpatient Specialty Care Primary Care

Goals and Metrics

Related Pathway

Behavioral Health Issues

Suspected Foreign Body Ingestion

IMAGING
AP single view (chest, neck, abdomen)
Lateral if: Battery/magnet suspected Esophageal location
FB location uncertain
All coins

Triage, Imaging

Resuscitation Room:
Impending/Existing
Respiratory or Circulatory Failure

MD/CRNP/RN Rapid Assessment
History and Physical, Imaging

Button Batteries

Button Battery Notification
Notify ENT, GI and OR to expedite patient to OR
Allows patient’s transferred from OSH to go directly to OR
Pre-hospital recommendations
National Capital Poison Center +
Button Battery Ingestion Triage and Treatment Guideline +
National Battery Ingestion Hotline: 800-498-8666

Coins/Blunt Objects

Magnets

Single
Multiple

Sharp Objects

Radiopaque or Suspected Radiotranslucent

Non-Radiopaque/
Special Circumstances

General Timing of Endoscopy

Food Impaction

Other Foreign Bodies

GENERAL TIMING OF ENDOSCOPY

Emergent (ASAP)	Urgent (< 24 Hours)	Non-Urgent (> 24 Hours)
Esophageal Location BUTTON BATTERY – NO DELAY Obstructive symptoms Respiratory distress Significant pain Sharp pointed objects Multiple magnets Stomach Location Multiple magnets	Esophageal Location Minimal symptoms Sharp longer objects in stomach with no symptoms	Stomach Location FB ≥ 2 cm wide and ≥ 5 cm long

IMPORTANT PHONE NUMBERS
Operating Room 5-4444
Poison Control Center (PCC) 4-2100 or 800-222-1222
Nat'l Battery Ingestion Hotline 202-625-3333

Posted: July 2013
Revised: January 2016, August 2016, September 2018, November 2018
Authors: P. Mamula, MD, S. Sobol, MD, C. Ford, MD

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References

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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.

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