Introduction

The Royal College of Emergency Medicine (RCEM) published a best practice guideline in 2021 for the management of children presenting with suspected ingestion of super-strong rare earth magnets (REMs).1 The guidelines highlight the importance of raising awareness of the risks associated with such ingestion and provide guidance on clinical management.1 A National Patient Safety Alert has highlighted that over a recent 3.5-year period there were 24 incidents of delay in assessment/treatment of children who presented with REM ingestion.2

Reasons identified were: unwitnessed ingestion, adopting a ‘watch and wait’ approach considered appropriate for other swallowed items, reluctance for lateral X-ray projections and abdominal X-ray (AXR) by radiology teams, and delay in surgical review/intervention.1 2

A service review by the Quadri-South East Paediatric Surgeons Group, which comprises of four tertiary paediatric surgical centres, reported that 251 children were admitted with foreign body ingestion over a 5-year period (January …