[Chronic habitual foreign body ingestion in German emergency departments-Results of a nationwide survey of medical emergency department heads].

BACKGROUND

Chronic habitual foreign body ingestion (chFI) in adults represents a rare but clinically relevant challenge in emergency medicine. Recurrent presentations, high resource consumption and the need for interdisciplinary care further complicate the management. To date, there is a lack of systematic data on the current care reality in German emergency departments (ED).

OBJECTIVE

To evaluate the frequency, hospital resource demands and structural challenges associated with chFI as perceived by heads of medical EDs.

METHODS

A nationwide anonymous online survey was conducted among medical directors of German EDs using a standardized questionnaire. Structural, clinical and organizational aspects of care were assessed. Data were analyzed descriptively. Free-text responses were evaluated using inductive category development.

RESULTS

Of the 1081 e‑mail invitations sent 831 (77%) were successfully delivered; 167 institutions participated in the survey (response rate: 20%). A total of 45% reported ≥ 15 presentations of patients with chFI per year. In 88% of cases endoscopy was performed as an emergency procedure, mostly outside of regular working hours. In addition to the ED and endoscopy unit, intensive care (47%) and psychiatry (34%) were frequently involved. In 66% of cases further treatment took place in a psychiatric hospital or ward. Key areas for improvement included early psychiatric involvement, clear indication criteria for endoscopy, and structured interdisciplinary collaboration.

CONCLUSION

The chFI represents a relevant challenge in emergency medicine. Repeated presentations and the lack of interdisciplinary treatment standards highlight the need for standardized care pathways with mandatory psychiatric integration.