SP1.12 - Who should manage recurrent foreign body ingestion? A questionnaire survey

Abstract Aims Recurrent foreign body ingestion (RFBI) associated with complex mental health illness is a common presentation to the emergency department. The aim of this study was to explore senior clinician’s experience and views on decision-making, support offered and management of patients with RFBI. Methods An anonymous survey, with questions on confidence in decision-making, support levels, and opinions on admitting specialty, was distributed to consultants and registrars in emergency medicine, gastroenterology, general surgery, and psychiatry. Results 189 responses with 166 complete surveys. 99% had encountered similar patients. 42% felt comfortable with decision-making. However, 35% felt stressed and 15% would delay or even avoid decision-making. Only 36% felt they received adequate support from legal and higher management teams and 84% were not aware of a management protocol. 60% were not confident in their knowledge of sectioning. 60% did not know when it is appropriate to call the police and 56% believe there is inadequate security staff support. 74% found difficulty referring to other specialties. 49% believe patients should be admitted under psychiatry, 29% believe admission should be under gastroenterology, and 22% believe they should be under surgery. Conclusion The majority of clinicians had encountered patients with RFBI but did not feel comfortable making management decisions for them. There is a lack of support, knowledge, and protocols surrounding management. There is difficulty referring between specialties and uncertainty on appropriate admitting specialty. There is a need for further research and guidance on management of these patients to increase collaborative teamworking and improve patient outcomes.