Things that go beep: experience with an ED guideline for use of a handheld metal detector in the management of ingested non-hazardous metallic foreign bodies.
OBJECTIVE
To review compliance with our emergency department (ED) guideline on the imaging of ingested non-hazardous metallic foreign bodies in children, investigate adverse outcomes, and make suggestions for improving the guideline.


METHODS
Retrospective analysis of patients presenting in a 3 year period to a paediatric ED with a history of possible metallic foreign body (MFB) ingestion, who were managed according to an ED guideline.


RESULTS
We identified 430 episodes of possible MFB ingestion, of which 422 were eligible for inclusion in the study. Compliance with the guideline was 77.8% with no significant adverse events. The exclusion of symptoms as a criterion for x ray results in a reduction in the x ray rate of 56% in the symptomatic group with no increase in adverse events.


CONCLUSIONS
A handheld metal detector (HMD) can be safely and reliably used in lieu of plain radiography to investigate children with a history of MFB ingestion, irrespective of symptoms and without incurring any significant adverse events.
Ramlakhan
S L
SL
Emergency Department, Sheffield Children's Hospital, Western Bank, Sheffield, UK.
Burke
D P
DP
Gilchrist
J
J
D000293:Adolescent; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D004064:Digestive System; D055590:Electromagnetic Phenomena / Q000295:instrumentation; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis* / Q000209:etiology; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D008297:Male; D008670:Metals; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies
D008670:Metals