Pediatric Coin Ingestion-Reply

In Reply.—We appreciate Dr Foster's interest in our article. Although the authors of the two studies^1,2 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