New Use of a Metal Detector

Lewis, Susan

doi:10.1542/peds.65.3.680b

Cited by 10 publications

(1 citation statement)

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“…A potential alternative is a hand‐held metal detector (HHMD). This was first described 40 years ago, 13 and studies have reported it to be a sensitive, non‐invasive test 14 . Potential benefits include reduction of radiation burden, improved ED patient flow and cost savings for health‐care systems 15 .…”

Section: What Is Already Known On This Topicmentioning

confidence: 99%

Ingestion of metallic foreign bodies: A Paediatric Emergency Research in the United Kingdom and Ireland survey of current practice and hand‐held metal detector use

Lafferty

Lyttle

Mullen

et al. 2021

J Paediatrics Child Health

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Aim To describe variation in the initial management of children presenting to Emergency Departments (ED) with coins lodged in the oesophagus. To determine the usage of hand‐held metal detectors (HHMDs) in EDs, including their role in clinical decision‐making, and training in their use. Methods Online multicentre cross‐sectional survey of EDs in the UK and Ireland, with results described using descriptive statistics. Results Fifty‐five (90%) of 61 sites responded. The two main strategies described for lodged oesophageal coins were endoscopic removal or observation with reassessment, dependent on location. For coins in the proximal third of the oesophagus 43/55 (78.2%) referred for endoscopic removal, 6/55 (10.9%) observed and the remaining 10.9% used a variety of methods, including: Foley catheter removal with fluoroscopy, blind Foley catheter removal, referral to paediatric surgery/ENT. Thirty (55%) of 55 used HHMDs, 21/30 (70%) had guidelines for their use, and 3/30 (10%) provided formal training. Twenty (67%) of 30 used the xiphisternum as the anatomical cut‐off for assuming safe passage of metallic foreign bodies (FB) beyond the lower oesophageal sphincter. Conclusions There is considerable variation in the management of oesophageal coins in children, though two dominant strategies were identified. As endoscopy is significantly more invasive than observation, future research should aim to determine whether either is more effective and safer in children. There is a clear division in departmental adoption of HHMDs. However, in those sites using HHMDs there was little formal training in their use, and there are large variations in techniques and their role in clinical decision‐making.

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Section: What Is Already Known On This Topicmentioning

confidence: 99%

Ingestion of metallic foreign bodies: A Paediatric Emergency Research in the United Kingdom and Ireland survey of current practice and hand‐held metal detector use

Lafferty

Lyttle

Mullen

et al. 2021

J Paediatrics Child Health

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Handheld Metal Detector Confirmation of Radiopaque Foreign Bodies in the Esophagus

Younger¹,

Darrow²

2001

Arch Otolaryngol Head Neck Surg

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Clinical outcome after near-fatal late shunt complication in hydrocephalus

Emanuelson¹,

Wendt²,

Kyllerman

et al. 1994

Child's Nerv Syst

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Shunt revision is inevitable in most shunted hydrocephalic children but the revisions rarely affect the prognosis markedly. This report presents the case of an otherwise healthy boy who, after an uneventful gestation and birth, manifested hydrocephalus in the neonatal period and was shunted at the age of 3 months. His subsequent development and school performance were normal until the age of 10 years, when he developed his first episode of shunt dysfunction. During the emergency shunt revision, intraventricular haemorrhage occurred, causing acute neurological symptoms and signs. In the promptly undertaken reoperation external drainage was inserted but accidentally without a functioning air needle. The intracranial pressure (ICP) rose to 40 cm H2O before correction. These incidents were followed by a 4-month period of unstable shunt function (12 reoperations) and deteriorating neurology. When stable shunt function was eventually achieved, he had severe contractures, minimal active motor function and no active speech. During a 2-year period of rehabilitation, he recovered almost normal motor function and normal intellectual function. Memory functions, vigilance and concentration span remained clearly subnormal. He returned to normal school and his performance is average. It is concluded that the relatively favourable outcome is the probable result of reversible partial herniation and increased ICP.

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New Use of a Metal Detector

Cited by 10 publications

References 0 publications

Ingestion of metallic foreign bodies: A Paediatric Emergency Research in the United Kingdom and Ireland survey of current practice and hand‐held metal detector use

Ingestion of metallic foreign bodies: A Paediatric Emergency Research in the United Kingdom and Ireland survey of current practice and hand‐held metal detector use

Handheld Metal Detector Confirmation of Radiopaque Foreign Bodies in the Esophagus

Clinical outcome after near-fatal late shunt complication in hydrocephalus

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