Utilizing a critical airway response team expedites esophageal button battery removal

Kylie Brandt; Katerina Dukleska; Morgan McKeown; John Brancato; Victoria Grossi; Scott Schoem; Tina Sacco; Jennifer D'Amato; Michael D Bourque; Brendan T Campbell

doi:10.1016/j.jpedsurg.2023.01.037

Utilizing a critical airway response team expedites esophageal button battery removal

J Pediatr Surg. 2023 May;58(5):810-813. doi: 10.1016/j.jpedsurg.2023.01.037. Epub 2023 Jan 19.

Authors

Affiliations

¹ Division of Pediatric Surgery, Connecticut Children's Medical Center, Hartford, CT, USA.
² Division of Pediatric Surgery, Connecticut Children's Medical Center, Hartford, CT, USA; Department of Surgery, University of Connecticut School of Medicine, Farmington, CT, USA. Electronic address: kdukleska@connecticutchildrens.org.
³ Department of Emergency Medicine, Connecticut Children's Medical Center, Hartford, CT, USA.
⁴ Department of Gastroenterology, Connecticut Children's Medical Center, Hartford, CT, USA.
⁵ Department of Otolaryngology, Connecticut Children's Medical Center, Hartford, CT, USA.
⁶ Division of Pediatric Surgery, Connecticut Children's Medical Center, Hartford, CT, USA; Department of Surgery, University of Connecticut School of Medicine, Farmington, CT, USA.

PMID: 36805142
DOI: 10.1016/j.jpedsurg.2023.01.037

Abstract

Background: Esophageal button battery ingestion is a significant problem that can lead to significant complications such as tracheoesophageal fistula, esophageal perforation, and aortoesophageal fistula. Due to this, prompt recognition and treatment is integral in the care of these patients.

Methods: Patients who presented to a single institution from August 2015 to April 2022 with esophageal button battery ingestion were included in this study. All esophageal button battery ingestion patients were included in a clinical algorithm for Critical Airway Response Team (CART) activation in October 2019. Time from diagnosis to treatment was compared for pre-CART clinical algorithm implementation to post-CART.

Results: Data on pre-CART patients (n = 6) and post-CART patients (n = 7) was collected. Including esophageal button battery ingestions to CART activations shortened the time from chest x-ray to button battery removal from 73 ± 32 min to 35 ± 11 min (p < 0.05).

Conclusion: These data highlight the importance of implementation of a clinical care algorithm to shorten the time from diagnosis to treatment in patients with esophageal button battery ingestion.

Level of evidence: III.

Keywords: Button battery; Clinical algorithm; Surgery.

MeSH terms

Eating
Electric Power Supplies
Foreign Bodies* / complications
Foreign Bodies* / diagnostic imaging
Foreign Bodies* / therapy
Humans
Infant
Radiography
Tracheoesophageal Fistula* / etiology
Tracheoesophageal Fistula* / surgery