ABSTRACT
Objective@#This study aimed to determine the factors that affect successful esophageal foreign body (FB) removal using a Foley catheter and to identify methods to increase the success rate. @*Methods@#In this retrospective, cross-sectional study, we included pediatric patients who presented with esophageal FB impaction that was removed using a Foley catheter in the emergency departments of tertiary care and academic hospitals. We analyzed the effect of the patients’ age, sex, and symptoms; FB type, size, and location; Foley catheter size; complications during FB removal; duration between FB ingestion and removal; operator’s years of training; sedation; success rate of FB removal; endoscopy; and patient’s posture during FB removal on the success of Foley catheter-based FB removal. @*Results@#Of the 43 patients we enrolled, Foley catheter-based FB removal was successful in 81.4% (35/43) but failed in 18.6% (8/43) of patients; no FB-removal-related complications were reported. There was no significant association between the success rate of Foley catheter-based FB removal and any study variable. A higher number of years in training tended to increase the success rate of Foley catheter-based FB removal, although statistical significance was not achieved. @*Conclusion@#Children’s esophageal FB removal is a practical challenge in the emergency rooms, and using a Foley catheter is associated with a high success rate of the removal and low occurrence of complications. In this study, no single variable was found correlated with the success rate of Foley catheter-based esophageal FB removal in pediatric patients, which may indicate multiple variables interacting with one another to affect the success rate.
ABSTRACT
Objective@#This study aimed to determine the factors that affect successful esophageal foreign body (FB) removal using a Foley catheter and to identify methods to increase the success rate. @*Methods@#In this retrospective, cross-sectional study, we included pediatric patients who presented with esophageal FB impaction that was removed using a Foley catheter in the emergency departments of tertiary care and academic hospitals. We analyzed the effect of the patients’ age, sex, and symptoms; FB type, size, and location; Foley catheter size; complications during FB removal; duration between FB ingestion and removal; operator’s years of training; sedation; success rate of FB removal; endoscopy; and patient’s posture during FB removal on the success of Foley catheter-based FB removal. @*Results@#Of the 43 patients we enrolled, Foley catheter-based FB removal was successful in 81.4% (35/43) but failed in 18.6% (8/43) of patients; no FB-removal-related complications were reported. There was no significant association between the success rate of Foley catheter-based FB removal and any study variable. A higher number of years in training tended to increase the success rate of Foley catheter-based FB removal, although statistical significance was not achieved. @*Conclusion@#Children’s esophageal FB removal is a practical challenge in the emergency rooms, and using a Foley catheter is associated with a high success rate of the removal and low occurrence of complications. In this study, no single variable was found correlated with the success rate of Foley catheter-based esophageal FB removal in pediatric patients, which may indicate multiple variables interacting with one another to affect the success rate.
ABSTRACT
PURPOSE: The aim of this study was to survey the accuracy of registration as anaphylaxis codes and the clinical characteristics of anaphylaxis registered correctly and incorrectly in pediatric anaphylaxis. METHODS: This study was conducted retrospectively using the medical records of patients under 15 years who visited a training hospital Emergency Department (ED) for 5 years. The study subjects were divided into the correct group (registered as anaphylaxis codes correctly) and the incorrect group (registered as other anaphylaxis related codes). RESULTS: Of the 133 patients, 14 belonged to the correct group and 119 to the incorrect group. The median age of the correct group was 9 years old and that of the incorrect group was 2 years old. Sex, transportation to the ED, elapsed time from exposure to ED arrival, past history of allergy, causes of anaphylaxis except drug, severity of symptom, mental status, and antihistamine use were not different between the 2 groups. Drugs as the cause of anaphylaxis and cardiovascular/neurologic symptoms were more common in the correct group. Gastrointestinal symptoms were more frequent in the incorrect group. Intravenous fluid, steroid, bronchodilator, and epinephrine were more commonly used as the treatment for anaphylaxis in the correct group. The pediatric patients treated with epinephrine tended to be registered anaphylaxis correctly. CONCLUSION: More patients were registered incorrectly as other anaphylaxis-related disease codes rather than correctly as the anaphylaxis disease codes in pediatric anaphylaxis. Epinephrine use was the associated factor for being registered correctly as the anaphylaxis disease codes in pediatric anaphylaxis.