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Handheld Metal Detector Screening for Metallic Foreign Body Ingestion in Children
04:55

Handheld Metal Detector Screening for Metallic Foreign Body Ingestion in Children

Published on: September 11, 2018

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Electronic medical record-based tools aid in timely triage of disc-shaped foreign body ingestions

Jennifer M Lavin1,2, Joshua Wiedermann1,2, Alexandra Sals3

  • 1Division of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.

The Laryngoscope
|September 20, 2018
PubMed

Insights

Urgent evaluation of coin-shaped foreign body ingestion in children is crucial. Implementing electronic medical record tools significantly improved triage timeliness and care initiation for these patients.

Area of Science:

  • Pediatric Emergency Medicine
  • Medical Informatics
  • Patient Safety

Background:

  • Coin-shaped foreign body (FB) ingestion in children requires urgent evaluation to exclude button battery ingestion.
  • Delays in triage can lead to increased patient injury, especially when patients appear well.

Purpose of the Study:

  • To assess the impact of an electronic medical record (EMR)-based quality initiative on the timeliness of care for children with coin-shaped FB ingestion.
  • To improve the accuracy of acuity assignment and reduce the time to diagnostic imaging.

Main Methods:

  • A quality initiative using EMR tools was implemented at an academic children's hospital.
  • A specific chief complaint and best practice advisory were created to ensure prompt triage and imaging orders.
  • A retrospective review compared patient care before and after the initiative.

Main Results:

  • Appropriate acuity assignment increased from 63.8% to 100% postimplementation (P = .0003).
  • Median time from arrival to imaging order placement decreased from 36.5 to 4 minutes.
  • Median time from arrival to imaging completion decreased from 59 to 41 minutes.

Conclusions:

  • EMR-based tools significantly improved the timeliness of care initiation for pediatric patients with metallic FB ingestion.
  • Further initiatives are planned to optimize downstream diagnostic and treatment processes.
Abstract

Keywords:
Electronic medical recordbutton batteryclinical decision supportesophageal foreign bodyingestion

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