Here at Valley Childrens our approach is the following:
Upper esophagus (usually coins), less than 6-12 hours since ingestion-
removed by the radiologist with a Foley catheter under fluoroscope.
Sharp objects or anything lodged for over 12-24 hours are removed by the
surgeon in the OR.
FB in the hypopharynx- I remove those in the ER after a little Versed, with
a laryngoscope and a Magill forceps.
Intragastric objects, including alkaline batteries- we just watch them to
be eliminated naturally in the next few days. Perforation, although
mentioned in the literature, I have yet to see one come in the ER.
UCSF/Fresno & Valley Childrens Hospital
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P.S. I wish I was an ER Resident in Australia so I could just read all day
and play with my computer, instead of working my gluteus off in the ER
night after day....Anybody agrees?