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Gregory P. Conners, MD
Department of Emergency Medicine University of Rochester Medical Center 601 Elmwood Ave Box 655 Rochester, NY 14642

James M. Chamberlain, MD; Daniel W. Ochsenschlager, MD
Washington, DC

Arch Pediatr Adolesc Med. 1995;149(11):1287.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

We appreciate Dr Schmitt's interest in our recent article.¹ As we noted, our data were retrospectively collected from the charts of all patients seen in a pediatric emergency department over an 18-month period. As Dr Schmitt notes and Paul et al² have shown, this is a somewhat different population from those patients managed exclusively in a primary care setting. Because of these differences, we were unable to formally assess the cost-effectiveness of obtaining a radiograph for most asymptomatic children who have swallowed a coin. However, since an asymptomatic child may have an esophageal coin, we concluded that the safest approach would be to obtain a radiograph after 24 hours, allowing the child sufficient time to possibly pass the coin while staying within the 24-hour period during which esophageal mucosal inflammation has been shown to be minimal.³ Although waiting 72 hours before ordering a radiograph to . . . [Full Text PDF of this Article]

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