Foreign body ingestions in children: Risk of complication varies with site of initial health care contact: Paul RI, Christoffel KK, Binns HJ, et al Pediatrics 91:121–127 Jan 1993

✍ Scribed by Vada Maxey

• Publisher: Elsevier Science
• Year: 1993
• Tongue: English
• Weight: 120 KB
• Volume: 22
• Category: Article
• ISSN: 1097-6760
• DOI: 10.1016/s0196-0644(05)82761-1

✦ Synopsis

This prospective study evaluates outcomes in pediatric foreign body ingestions relative to the site of initial health care contact. The authors challenge current recommendations for management that are based on studies that included only children seen in hospital settings. This study enrolled 244 children through three sources: selfreferred to pediatric emergency department, referred to pediatric ED after initial evaluation elsewhere, and patients reporting ingestions to private pediatricians. As seen in previous studies, coins were the most common item ingested; however, in contrast to other studies, the subjects in this study had a low incidence of developmental abnormalities or esophageal disease. Complications occurred at much higher rates in patients referred after evaluation elsewhere (63%) than in the self-referred patients (13%) 'or those reporting to private pediatricians (7%). Similarly, procedures were required more often for those patients initially evaluated elsewhere (67%) than for those selfreferred to EDs (16%) or reporting to private pediatricians (7%). The authors suggest additional studies to establish management guidelines for asymptomatic foreign body ingestions. They further recommend using studies that include nonhospital patients for establishing standards of care because hospital-based studies may reflect higher rates of procedures and complications.