Screening for iron deficiency anemia in at risk children in the pediatric emergency department: a survey of Canadian pediatric emergency department physicians.
OBJECTIVE
To determine the attitudes and reported practices of physicians regarding screening for iron deficiency anemia in at-risk children in pediatric emergency departments (PEDs) across Canada.


METHODS
A standardized survey was mailed to 183 PED physicians at 10 tertiary care PED across Canada. The practices and attitudes regarding screening for iron deficiency anemia were collected via a questionnaire consisting of single select closed-ended items and items which required ranking in order of importance.


RESULTS
Sixty-one percent (111/183) of physicians responded to the survey. Ninety-six percent of respondents do not routinely screen for iron deficiency anemia. One third of respondents believed that screening for iron deficiency anemia in the PED is possible. The remaining stated lack of time, difficulty with follow-up, it not being an emergent issue and cost as prohibitive factors. One third of participants stated that 21% to 40% of the pediatric patients seen in their PED did not have a primary care physician. The main considerations in deciding on whom to perform venipuncture were based on dietary history and physical examination with a history of consumption of milk greater than 24 ounces per day (94%) and conjunctival or skin pallor (97%, 94%, respectively) selected as the most important items.


CONCLUSIONS
The results of this study indicate that Canadian PED physicians are not routinely screening for iron deficiency anemia, although they demonstrate knowledge of the risk factors for iron deficiency anemia and recognize the importance of diagnosis and treatment to prevent long-term morbidity.
Berard
Roberta
R
Department of Pediatrics, University of Western Ontario, Children's Hospital of Western Ontario, London, Ontario, Canada. bobbi.berard@sympatico.ca.
Matsui
Doreen
D
Lynch
Tim
T
D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D000818:Animals; D001291:Attitude of Health Personnel; D001942:Breast Feeding / Q000706:statistics & numerical data; D002170:Canada; D002417:Cattle; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003625:Data Collection; D004522:Educational Status; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D007223:Infant; D007225:Infant Food / Q000009:adverse effects; D007231:Infant, Newborn; D007239:Infections; D004930:Inuit / Q000706:statistics & numerical data; D019266:Iron, Dietary; D008403:Mass Screening / Q000191:economics / Q000458:organization & administration / Q000523:psychology; D008892:Milk / Q000009:adverse effects; D008895:Milk, Human; D010290:Parents / Q000523:psychology; D010372:Pediatrics / Q000458:organization & administration / Q000706:statistics & numerical data*; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012306:Risk; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D019564:Unnecessary Procedures; D044465:White People / Q000706:statistics & numerical data; D000078329:Workforce
D019266:Iron, Dietary