This method can help answer key questions in the field of pediatric emergency medicine, such as screening for metallic foreign body ingestion in children. The main advantage of this technique is that it is a very effective, rapid screening tool and it uses a radiation-free equipment. The implications of this technique extend to its early analysis of metallic foreign body ingestion in children by introducing handheld metal detector screening early in the child's process.
The number of radiographs being ordered to locate the metallic foreign body can be reduced in this radio-sensitive population. Though this method can provide insight into early detection of ingested metallic foreign bodies in children during the initial emergency department visit, it can also be applied to follow up on the course and passage of ingested metallic foreign bodies. Generally, individuals new to this method might struggle because all of the relevant anatomical areas must be scanned thoroughly.
Visual demonstration of this method is critical as patient preparation and systematic metal detector screening can be difficult steps to learn. Inadequate patient preparation can lead to false negative results. After screening the patient according to the text protocol, dress the patient in a hospital gown.
After this, remove all items from the patient that may contain metallic objects. Ensure that the patient is moved away from all metallic objects to avoid interference with metal detector screening. Place the patient in the center of the room away from any potential metallic interference.
After this, remove all metallic accessories such as jewelry or watches. Then, instruct the patient's caregiver to remove any of their metallic accessories. First, confirm the working status of the handheld metal detector, or HHMD.
Then, instruct the patient to stand up for the exam and hold the patient's hands up and away from the body. Next, position the patient's head to extend and expose the neck. Start the scan from the chin and end the scan at the level of the hip joint.
Perform the scan in a zigzag manner across the body to ensure that every area has been scanned. It is of paramount importance to scan all the relevant anatomical areas thoroughly, so that no potential areas are missed. Take the thickness of the patient into consideration and scan both anteriorly and posteriorly.
During the scan, note any positive audiovisual signals from the HHMD. After performing the HHMD scan, order the relevant neck, chest, and abdominal radiographs. Next, correlate the positive HHMD signal with the underlying bony landmark on the body by palpating the sternal notch, xiphisternum, pubic symphysis, and the bilateral iliac crest.
Finally, record the test results in the logbook. In this study, 36 pediatric patients were recruited when they presented to the emergency department with a history of foreign body ingestion. Of the 36 patients, 28 had metallic foreign body ingestions with coins being the most common type of foreign body ingested.
The overall sensitivity and specificity of the HHMD to detect ingested metallic objects was 100%as validated by plain radiographs. While attempting this procedure, it is important to remember to move the patient away from all metallic objects to avoid interference with the metal detector screening and scan all the relevant anatomical areas thoroughly so that no potential areas are missed. Following this procedure, other methods, like x-ray examination, can be carried out to determine the specific anatomical location of the metallic foreign body.
After it's development, this technique will allow researchers in the field of emergency medicine to explore alternative methods for repeat trial screening of metallic foreign body ingestion in pediatric patients.
