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Pediatric coin ingestion: a home-based survey
G P Conners1, J M Chamberlain, P R Weiner
1Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, NY, USA.
Insights
Most pediatric coin ingestions are managed at home without medical intervention and have no adverse outcomes. This suggests current studies may overestimate the incidence and complications of coin ingestion in children.
Area of Science:
- Pediatric Medicine
- Toxicology
- Public Health
Background:
- Coin ingestion is a common pediatric emergency.
- Understanding the natural history is crucial for appropriate management.
- Existing data may be skewed by hospital-based reporting.
Purpose of the Study:
- To determine the incidence and management of pediatric coin ingestions.
- To assess the outcomes of coin ingestions managed at home versus medically.
- To evaluate the limitations of hospital-based data for coin ingestion studies.
Main Methods:
- Anonymous, home-based mail survey of parents in suburban Maryland.
- Survey targeted families associated with a five-physician private pediatric practice.
- Data collected on coin ingestion incidence, age, management, and outcomes.
Main Results:
- Survey response rate was 35.3% (798/2,263 families), representing 1,510 children.
- Coin ingestion occurred in 4.0% of children (61/1,510) at a mean age of 2.8 years.
- 85% of coin ingestions were managed at home without physician or poison control contact; no adverse outcomes were reported.
Conclusions:
- Most pediatric coin ingestions are asymptomatic and managed conservatively at home.
- Home-based management is safe and effective for the majority of coin ingestions.
- Hospital- and poison control center-based studies likely overestimate coin ingestion incidence and complication rates.
Abstract:
To improve understanding of the natural history of pediatric coin ingestions, an anonymous, home-based mail survey of parents followed by a five-physician private pediatric practice in suburban Maryland was conducted. Of 2,263 families surveyed, 798 (35.3%) responded, representing 1,510 children. Sixty-one (4.0%, 95% confidence interval: 3.1% to 5.1%) children had swallowed a coin, at a mean age of 2.8 years. Fifty-two (85%) coin ingestions were managed at home, usually without calling a physician or poison control center. Only 9 (15%) children were examined by a physician. No child (95% confidence interval: 0% to 4.9%) underwent a removal procedure or had an adverse outcome. Most coin ingestions were found to have been managed at home, often without calling a physician or poison control center. Hospital- or poison control center-based studies underestimate coin ingestion incidence and overestimate the frequency of complications.