Foreign-body Ingestions in Children During COVID-19 Pandemic in a Pediatric Referral Center

Pizzol, Antonio; Rigazio, C.; Calvo, Pier Luigi; Scottoni, Federico; Pane, Alessandro; Gennari, Fabrizio; Cisarò, Fabio

doi:10.1097/pg9.0000000000000018

Cited by 30 publications

(30 citation statements)

References 8 publications

(10 reference statements)

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“…The Regina Margherita Children's Hospital in Italy did a retrospective study of foreign body ingestions during February 24 to April 24, 2020, comparing this to the same time period the prior 4 years. This went from 0‐3 battery ingestion cases in this time period annually in 2016‐2019, to 9 cases in the same period in 2020; this was a statistically significant increase ( p < 0.001) 29 . A recent report from the U.S. CPSC demonstrated a 93% increase in battery related emergency room visits during March to September 2020 compared to same time period, in 2019 in children ages 5‐9 30 .…”

Section: Introductionmentioning

confidence: 74%

Current management of button battery injuries

Sethia

Gibbs

Jacobs

et al. 2021

Laryngoscope Investig Oto

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Button batteries (BB) are found in common household items and can lead to significant morbidity and mortality in the pediatric population when ingested. BBs are made of various chemistries and have a unique size and shape that yield significant injury when lodged in the pediatric esophagus. BBs create a local tissue pH environment of 10 to 13 and can induce liquefactive necrosis at the negative pole. This initial injury can progress with further tissue breakdown even after removal. Unfortunately, patients may present with vague symptoms similar to viral illnesses and there is not always a known history of ingestion. Plain film X‐ray can be diagnostic. Exposure can lead to caustic injury within 2 hours. Thus, timely endoscopic removal is the mainstay of treatment. Novel mitigation and neutralization strategies have been implemented into treatment guidelines. These include the preremoval ingestion of honey or sucralfate and intraoperative irrigation with acetic acid. Depending on the severity of injury following removal, careful consideration should be given for potential delayed complications including fistulization into major vessels which often leads to death. The National Button Battery Taskforce and several industry members have implemented prevention strategies such as educational safety outreach campaigns, child‐resistant packaging changes, and warning labels. Governmental regulation and industry changes are key to limit not only the amount of BB ingestions, but also the devastating consequences that can result. Anonymous reporting of BB injuries through the Global Injury Research Collaborative has been made convenient and centralized through the advent of a user‐friendly smartphone iOS/App Store and Android/GooglePlay application called the “GIRC App”; all specialists who manage foreign body cases should contribute their cases to help prevent future injuries. BB ingestion must be recognized and treated promptly using a multidisciplinary approach to optimize outcomes for these patients. Ultimately, a safer BB technology is critically needed to reduce or eliminate the severe and life‐threatening injuries in children. Level of Evidence 5

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Section: Introductionmentioning

confidence: 74%

Current management of button battery injuries

Sethia

Gibbs

Jacobs

et al. 2021

Laryngoscope Investig Oto

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“…Bram et al [ 28 ] reported that there was a significant decrease in the incidence of pediatric fractures after the COVID-19 outbreak compared to pre-COVID-19 and the proportion of injuries occurring at home (32.5% to 57.8%) had increased, but those related to sports (26.0% to 7.2%) or playgrounds (9.0% to 5.2%) had decreased. In Italy, there was a dramatic increase in battery ingestions in children during the COVID-19 pandemic lockdown [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of Covid-19 on the Visit of Pediatric Patients with Injuries to the Emergency Department in Korea

et al. 2021

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The total number of pediatric emergency department (PED) visitors has decreased worldwide since the coronavirus disease (COVID-19) outbreak. We hypothesized that this might also affect the number of PED visits due to injuries. Therefore, we investigated these changes in PED visits after the COVID-19 outbreak through a long-term multicenter observational study. We assessed the changes in the proportion of injured pediatric patients’ weekly visits and the trend in the rate changes since the COVID-19 epidemic began by segmented regression analysis. We also evaluated the weekly change in the distribution of detailed diagnostic codes among pediatric patients with injuries before and after the COVID-19 pandemic. The proportion of injury-related PED visits increased when COVID-19 was first confirmed in Korea. After the COVID-19 epidemic, the proportion of foreign body ingestions and fracture patients among all pediatric patients with injuries increased significantly every week. The changes in the proportion of injured pediatric patients after the COVID-19 outbreak may have been the result of social distancing to prevent the spread of the virus. The risk of pediatric infections decreased but the risk of injury remained. Therefore, parents should take precautions to prevent infectious diseases and be careful to prevent children’s injuries at home.

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“…A statistically significant increase in button battery ingestions was noted during the pandemic. 18 Furthermore, a study investigating ear, nose and throat (ENT) emergency admissions during the COVID-19 pandemic found that while attendances for ENT symptoms showed a statistically significant reduction, attendances for foreign body ingestions continued to remain high. 19 The findings from our study echo this trend and thus highlight the importance of raising awareness to increasing rates of foreign body ingestion.…”

Section: Discussionmentioning

confidence: 99%

“…UNESCO states that during the COVID-19 pandemic, 1.37 billion students globally have been unable to attend school resulting in an abrupt change in family lifestyle. 20 Pizzol et al 18 studied 101 cases of foreign body ingestion and found nearly all happened at home. The relationship between foreign body ingestion and the home environment has been previously explored.…”

Section: Discussionmentioning

confidence: 99%

Foreign body ingestion during the COVID-19 pandemic: a retrospective single centre review

Festa

Thakkar

Hewitt

et al. 2021

bmjpo

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IntroductionDuring the COVID-19 pandemic in 2020, there were many changes in the provision of healthcare as well as home and educational environments for children. We noted an apparent increase in the number of children presenting with ingested foreign bodies and due to the potential impact of injury from this, further investigated this phenomenon.MethodUsing a prospective electronic record, data were retrospectively collected for patients referred to our institution with foreign body ingestion from March 2020 to September 2020 and compared with the same period the year prior as a control.ResultsDuring the 6-month pandemic period of review, it was observed that 2.5 times more children were referred with foreign body ingestion (n=25) in comparison to the control period (n=10). There was also a significant increase in the proportion of button battery and magnet ingestions during the COVID-19 pandemic (p 0.04).ConclusionThese findings raise concerns of both increased frequency of foreign body ingestion during the COVID-19 pandemic and the nature of ingested foreign bodies linked with significant morbidity. This may relate to the disruption of home and work environments and carries implications for ongoing restrictions. Further awareness of the danger of foreign body ingestion, especially batteries and magnets, is necessary (project ID: 2956).

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Foreign-body Ingestions in Children During COVID-19 Pandemic in a Pediatric Referral Center

Cited by 30 publications

References 8 publications

Current management of button battery injuries

Current management of button battery injuries

Impact of Covid-19 on the Visit of Pediatric Patients with Injuries to the Emergency Department in Korea

Foreign body ingestion during the COVID-19 pandemic: a retrospective single centre review

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