Lead Poisoning in Children: Early Detection, Intervention and Prevention
Part II: Clinical Treatment Guidelines
The Childhood Blood Lead Clinical Treatment Guidelines for Minnesota were officially released in July 2001. They represent the consensus opinion of eight physicians experienced in treating patients with EBLLs. Establishing criteria for initiation of Chelation therapy and Chelation efficacy were extensively discussed by the work group in developing these guidelines.
The guidelines are endorsed by the MMA, Minnesota Chapter of the AAP, the MAFP, and the Minnesota Nurses Association (MNA).
C&TC providers should be using the Childhood Blood Lead Clinical Treatment Guidelines (PDF) [updated March 2011].
The following chart is a summary of those guidelines:
|If result of capillary screening test is (micrograms per deciliter: mcg/dL)||Perform diagnostic test on venous blood within:|
|5 - 9.9 mcg/dL||3 months; provide written, culturally appropriate lead poisoning prevention literature|
|10 - 14.9 mcg/dL||3 months|
|15 - 44.9 mcg/dL||1 week|
|45 - 59.9 mcg/dL||48 hours|
|≥ 60 mcg/dL||Immediately (as an emergency lab test)|
REFERRAL CRITERIA for Public Health Nurses (PHN)
PHNs who perform C&TC well child exams must report any BLL that is 5 mcg/dL or more to the child's primary care provider and initiate family education on sources of environmental lead and lead poisoning. The PHN should follow up with the family to ensure confirmatory venous testing has occurred within the time frame indicated on the chart above.