Pediatric Esophageal Button Battery Protocol Reduces Time From Presentation to Removal

Objective Evaluate implementation of an institutional protocol to reduce the time to removal of esophageal button battery (BB) and increase use of mitigation strategies. Methods We developed a protocol for esophageal BB management [Zakai's Protocol (ZP)]. All cases of esophageal BB impaction managed at a tertiary care center before and after implementation from 2011 to 2023 were reviewed. Time to BB removal, adherence to critical steps, and use of mitigation strategies (honey/sucralfate, acetic acid) were evaluated. Results Fifty‐one patients (38 pre‐ZP, 13 post‐ZP) were included. Median age was 2.3 years (IQR 1.3–3.4). After implementation, the time from arrival at the institution to arrival in the operating room (OR) reduced by 4.2 h [4.6 h (IQR 3.9–6.5) to 0.4 h (IQR 0.3–0.6), p