Related Experiment Video
Updated: Jun 4, 2026

Image Acquisition using Portable Sonography for Emergency Airway Management
Published on: September 28, 2022
Esophageal coin removal by emergency physicians: a continuous quality improvement project incorporating rapid
1Loma Linda Medical University Medical Center and Children's Hospital, Loma Linda, CA 92354, USA. rishbhar@yahoo.com
Objective:
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.
Related Concept Videos
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
Endotracheal Intubation I: Procedure
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
Endoscopic Procedures V: ERCP
Patient...
Cardiopulmonary Resuscitation II: ACLS Airway Management
Endotracheal Intubation II: Nursing Management
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:

