Emergency Department Clinical Pathway for the
Evaluation/Treatment of Children with Foreign Body Ingestion
Triage Imaging
AP chest X-ray
AP chest X-ray
Suspected Foreign Body (FB) Ingestion
Button Battery Referral to CHOP PHL
- Child with confirmed esophageal, nasal or airway button battery
- Activate Button Battery Notification
- Notifies: ENT, GI, Gen Surg, OR
- Child goes directly to OR
- Pre-hospital Recommendations
- Antibiotic Prophylaxis
- Consider for severe esophageal injury, perforation, fever
- Cross-sectional imaging per
ENT/GI Consult
ED Triage, Imaging
Resuscitation Room
Impending/existing
respiratory or
circulatory failure
Impending/existing
respiratory or
circulatory failure
Suspected ingested
or nasal button battery
Notify PEM and expedite X-ray
or nasal button battery
Notify PEM and expedite X-ray
Confirmed Esophageal Button Battery
Activate Button Battery Notification
Emergent endoscopic removal
OR Board Runner 5-4444
Activate Button Battery Notification
Emergent endoscopic removal
OR Board Runner 5-4444
- Button Battery Ingestion Triage and Treatment Guideline
- National Capital Poison Center
4-2100 or 800-222-1222 - National Battery Ingestion Hotline:
800-498-8666
Evidence
- Management of Ingested Foreign Bodies in Children: A Clinical Report of the NASPGHAN Endoscopy Committee
- 2021 Diagnosis, Management, and Prevention of Button Battery Ingestion in Childhood: A European Society for Paediatric Gastroenterology Hepatology and Nutrition Position Paper
- Current Management of Button Battery Injuries
- NBIH Button Battery Ingestion Triage and Treatment Guidelines
- The OH–NO of Pediatric Foreign Body Ingestions: Lithium Batteries (Button Batteries)
- 2011 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS)
- Review All Evidence