Lead Poisoning in Children: Emergency Department Recognition and Management

Points & Pearls Excerpt

• Identifying a child with severe lead poisoning can be challenging, as it is an uncommon entity with a nonspecific presentation and there is often lack of a known lead exposure.
• Patients may be asymptomatic or present with nonspecific gastrointestinal symptoms, unexplained neurologic findings, signs of anemia, and/or hypertension. Maintain a high index of suspicion for lead poisoning in patients presenting with these symptoms and no known cause.
• If there is suspicion for lead poisoning, obtain a comprehensive history to identify possible risk factors for lead exposure. (See Table 1.)
• When assessing a patient for lead poisoning, it is not necessary to order lead testing of urine, hair, teeth, or fingernails, since these tests are not as sensitive or specific;^45-47 a BLL is sufficient to make the diagnosis.