Esophageal button battery ingestions: Decreasing time to operative intervention by level I trauma activation |
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Authors: | Robert T Russell Russell L Griffin Elizabeth Weinstein Deborah F Billmire |
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Institution: | 1. Division of Pediatric Surgery, Children’s of Alabama, University of Alabama at Birmingham, Birmingham, AL, USA;2. Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA;3. Division of Emergency Medicine, JW Riley Hospital for Children, Indianapolis, IN, USA;4. Division of Pediatric Surgery, JW Riley Hospital for Children, Indianapolis, IN, USA |
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Abstract: | PurposeThe incidence of button battery ingestions is increasing and injury due to esophageal impaction begins within minutes of exposure. We changed our management algorithm for suspected button battery ingestions with intent to reduce time to evaluation and operative removal.MethodsA retrospective study was performed to identify and evaluate time to treatment and outcome for all esophageal button battery ingestions presenting to a major children’s hospital emergency room from February 1, 2010 through February 1, 2012. During the first year, standard emergency room triage (ST) was used. During the second year, the triage protocol was changed and Trauma I triage (TT) was used.Results24 children had suspected button battery ingestions with 11 having esophageal impaction. One esophageal impaction was due to 2 stacked coins. Time from arrival in emergency room to battery removal was 183 minutes in ST group (n = 4) and 33 minutes in TT group (n = 7) (p = 0.04). One patient in ST developed a tracheoesophageal fistula. There were no complications in the TT group.ConclusionsThe use of Trauma 1 activations for suspected button battery ingestions has led to more expedient evaluation and shortened time to removal of impacted esophageal batteries. |
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Keywords: | Button battery Level I trauma Esophagus |
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