‘Good continence care can empower patients’
Urgent assessment and treatment are “vital” following the ingestion by children or adults of so-called ‘super strong’ magnets, according to a safety alert issued to the NHS in England.
It warned that swallowing more than one of the magnets could lead to compression of bowel tissue that could then cause necrosis and perforation of the intestines or blood vessels “within hours”.
“Any delay has potential to increase the risk of significant harm”
A joint National Patient Safety Alert has been issued by NHS England and NHS Improvement and the Royal College of Emergency Medicine (RCEM) setting out urgent measures to be taken.
It said all organisations that provide urgent clinical assessment must “review and revise” protocols to ensure patients who have ingested ‘super strong’ magnets, or are suspected of doing so, are referred to an emergency department as a medical emergency.
Meanwhile, all organisations with emergency departments have been told to review and revise protocols for foreign body ingestion to ensure they align with the RCEM’s Best Practice Guideline.
Patients that have ingested more than one magnet, or a magnet with a metallic object, require time critical assessment and action, antero-posterior and lateral abdominal radiographs, repeat x-rays every six to 12 hours if they have not had surgical intervention, and an urgent review of x-rays.
In addition, an urgent surgical review is required for all symptomatic patients, according to the safety alert issued today.
Emergency departments should also review systems for access to radiologists or reporting radiographers, and develop “written safety netting information” for patients and their families, who are discharged without the magnets having been removed.
The alert is targeted at all organisations providing urgent or emergency care, including those with emergency departments, minor injury units, or urgent treatment centres, as well as GP practices and mental health services.
The alert was sparked after a review over a recent three-and-a-half-year period identified 24 incidents where patients experienced a delay in assessment or treatment.
“‘Super strong’ magnets are small in volume but powerful in magnetism and easily swallowed”
It said the delays were reported as causing moderate, low harm or none, but that it was difficult to separate the impact of any delays from the direct harm caused by swallowing the magnet.
“However, any delay has potential to increase the risk of significant harm,” warned the national safety alert.
It said: “Small powerful magnets, also known as neodymium or ‘super strong’ rare-earth magnets, are sold as toys, decorative items, and fake piercings and are becoming increasingly popular.
“Unlike traditional magnets, these ‘super strong’ magnets are small in volume but powerful in magnetism and easily swallowed,” noted the alert.
“If more than one ‘super strong’ magnet is swallowed separately, or a ‘super strong’ magnet is swallowed with a metallic object, then they can be strongly attracted together from different parts of the intestines,” it said.
“This compression of bowel tissue can cause necrosis and perforation of the intestines and/or blood vessels within hours.
“Therefore, urgent assessment and treatment is vital, including an antero-posterior (front) and lateral (side-on) abdominal x-ray and surgical review,” said the alert.
It added: “The risks of damage apply to children and adults of any size.”
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