THERE WERE OVER 2,300 attendances to the emergency departments (EDs) in Ireland’s three children’s hospitals as a result of children ingesting foreign objects since 2015.
Between the beginning of 2015 and June of this year, there were a total of 2,301 such attendances at the EDs at Temple Street Children’s University Hospital, Children’s Health Ireland at Crumlin and Tallaght University Hospital.
Temple Street had 918 attendances, while Crumlin and Tallaght had 897 and 486 respectively.
These figures were released to TheJournal.ie under the Freedom of Information Act.
Each record represents one attendance, meaning there’s a possibility that some children may have been treated more than once.
The release of the figures come after a US study, published in the journal Paediatrics in May, revealed that the rate of foreign-body ingestions among children under the age of 6 in the US almost doubled between 1995 and 2015, increasing by 91.5%.
A total of 759,074 children under the age of six were estimated to have been evaluated for foreign-body ingestions in US emergency departments over the study period.
No similar studies looking back over recent decades have been conducted here. Asked for his response in relation to Irish children’s hospitals, Temple Street lead paediatric emergency physician Dr Ike Okafor said he was not surprised at the figures.
“We see a few of them a week, maybe just one every couple of days. They’re usually preschool children, under five.”
The majority of cases tend not to be too serious, according to Dr Okafor, who said the most common items ingested by children are coins.
“Coins are straightforward. We usually leave them alone once they have gone below a certain point in the digestive tract. If it’s still very high up then there’s a risk that they can choke from it. They are the ones who go to theatre and they have it removed,” Dr Okafor said.
Not all items are as low-risk as coins, however.
Dr Okafor noted the dangers surrounding the ingestion of batteries.
“The problem with button batteries is that they are alkaline and the injury to the lining of the child’s stomach from swallowing a battery is as a result of both the alkaline and the electrical injury,” he said.
In 2015, Australian toddler Isabella Rees died after swallowing a button battery, according to ABC Australia.
What should an adult do if a child has swallowed an object?
If a child has ingested a foreign object, they should not be given water to drink, according to Dr Okafor.
“There’s a tendency for people to give kids who are choking water. You allow the child to cough away,” he said.
If the child has already swallowed the item and hasn’t choked at all, the best thing to do is to take the child to a GP or hospital, he added.
There’s no situation at all where [someone] should put their hands into a child’s mouth to try and retrieve something that the child has put into their mouth and they’re about to swallow it. That causes more damage.
“It makes the child panic and the child is more likely to choke on the object than successfully swallow it.”
If a child has eaten poison, the HSE advises to take the poison away, make them spit it out and run your fingers around the child’s mouth to flick out any remaining pieces.
The HSE warns not to make the child vomit and to keep the container in question, if there is one, as the doctor will need to see it.
If a child has swallowed a button cell battery, the HSE advises that the child be brought immediately to the nearest ED that admits children.
So, what measures can be taken to prevent such incidents?
First and foremost, small items that could be easily ingested should be taken out of reach of children, if possible. However, Dr Okafor noted that it can be difficult to completely prevent all risks.
“They tend to be quite adventurous at that age. One of the ways they interact with their environment is through their mouth, so they tend to put a lot of things into their mouths and by doing that they just end up swallowing it,” Dr Okafor said.
As much as possible, just try to look for little objects, coins, nails, stuff that the child could put into their mouth and swallow.
“You know how kids are, they have a very acute eyesight and they’re drawn to shiny things and within a second if you look the other way they’ll put it in their mouth,” he said.
If a child has been exposed to poison, the Poisons Information Line can be called on 01 809 2166. The service is available from 8am to 10pm every day. Outside of these hours, contact should be made with a GP or hospital. In an emergency, call 999 or 112.
More information about poisoning in young children can be found here.
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