Handheld Metal Detector Screening for Metallic Foreign Body Ingestion in Children

Summary

Here, we present a protocol to use the handheld metal detector, to screen for the presence of ingested metallic foreign bodies in children who present to the pediatric emergency medicine department with a history of foreign body ingestion.

Abstract

Coins are the most common ingested metallic foreign bodies among children. The goal of this protocol is to assess the accuracy and feasibility of using a handheld metal detector to detect ingested metallic foreign bodies in children. We propose that by introducing handheld metal detector screening early in the triage process of children with high suspicion of metallic foreign body ingestion, the number of radiographs being ordered to localize the metallic foreign body can be reduced in this radio-sensitive population. The study protocol requires the screening of the participants for history of foreign body ingestion and exclusion of patients with respiratory distress or metallic implants. The patient changes to hospital gown and items that could contain metal like eyeglasses, earrings, pendants, and ornaments are removed. The patient is positioned in the center of the room away from other metallic interferences. The working status of the handheld metal detector is first confirmed by eliciting a positive audio-visual signal. Then the screening is done in an erect position with head in extension to expose the neck, from the level of the chin to the level of the hip joint, to cover the anatomical areas from neck to pelvis in a zig-zag manner both anteriorly and posteriorly. A positive audio-visual signal is carefully noted during the scanning for the presence of metallic foreign body. Relevant radiographs are ordered as per the area detected on the metal detector screening. The handheld metal detector was able to precisely identify all the coins among the ingested metallic foreign bodies in our study. The handheld metal detector could not consistently detect non-coin metallic foreign bodies. This protocol demonstrates the accuracy of handheld metal detector in the identification and localization of coins and coin like metallic foreign bodies.

Introduction

Foreign body ingestion is a widespread problem among children presenting to the pediatric emergency department because of the natural inquisitive nature of infants and children to explore objects by tasting and swallowing them^1,2. Previous studies have reported that metallic objects constituted 85% of all foreign body ingestions in their cohort of patients^3,4. The goal of this protocol is to assess the accuracy and feasibility of using a handheld metal detector to detect ingested metallic foreign bodies in children. We propose that by introducing the h....

Protocol

The protocol follows the guidelines of Institutional Human Research Ethics committee. The central institutional review board provided the ethics approval for the study.

1. Participant Screening

1. Recruit patients who present to the pediatric emergency department with history of foreign body ingestion.
2. Exclude the patients who are in respiratory distress and has implanted devices like pace makers.

2. Prepare the Patient

1. Dress th.......

Discussion

Metallic foreign body ingestion in children is a common problem and in the majority of patients, this is managed conservatively^7,16. Single or repeated radiographs can expose the radio-sensitive pediatric population to unwanted radiation risk while attempting to localize the ingested metallic foreign body. Several studies have described the use of metal detectors in MFB ingestion in children, with sensitivity more than 96% and specificity greater than 80%

Materials

Name	Company	Catalog Number	Comments
Hand held metal detector	Garrett Super Scanner V	NA	NA