In Reply.—We appreciate Dr Foster's interest in our article. Although the authors of the two studies1,2 in question may have faculty appointments at the same university, the studies were performed independently, without knowledge of one another, and on entirely different patient populations. Dr Schunk and associates2 evaluated 52 patients presenting to an ED of a tertiary care children's hospital during a 12.5-month period. Some of their patients were referred to their institution specifically for coin removal. We prospectively studied 162 patients during a 28-month period who voluntarily called the Intermountain Regional Poison Control Center with a complaint of coin ingestion. There is evidence that children presenting to EDs are at a twofold to sixfold greater risk for symptoms, complications, and hospitalization from foreign-body ingestion than those presenting to an office practice with the same complaint.3 This suggests that the ED population represents a higher-risk group and
CARAVATI EM, McELWEE NE. Pediatric Coin Ingestion-Reply. Am J Dis Child. 1990;144(4):451–452. doi:10.1001/archpedi.1990.02150280072007
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