Elevated Venous Blood Lead Levels — Primary Care | Children's Hospital of Philadelphia

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Afghan Refugee, ED

Children ≤ 6 yrs with Venous Blood Lead Levels (VBLL)
≥ 3.5 μg/dL Due to Environmental Lead Exposure

VBLL ≥ 45, ED referral
Chelation
Contact Poison Control Center
1-800-222-1222

Laboratory Guidance for Lead Screening

Recommended Actions by VBLL

Medical Management
- Review sources of lead exposure
- Testing for household members
- Iron supplementation, Nutrition Counseling
- Schedule Follow-up Lead Testing
- Patient Education
- Early Intervention Referral as indicated
- Social Work referral for VBLL ≥ 10 μg/dL

Environmental Inspection and Remediation
- All VBLL ≥ 3.5 μg/dl
- Completed by DOH in Philadelphia
- Outside Philadelphia, facilitated by Medicaid insurance case management, if applicable

Ongoing Management
- Follow-up Lead Testing
- Re-assess iron deficiency anemia
- Confirm environmental inspection and remediation if necessary
- Patient Education

Lead level not declining
- Contact insurance company for
  case management
- Keystone First Rapid Response Team
- Health Partners Special Needs Unit
- UHC Bright Futures

Posted: December 2023
Revised: February 2024

Authors:
- E. Huang, MD;
- K. Osterhoudt, MD;
- E. Gregory, MD;
- K. McPeak, MD;
- J. Krzywicki, RN;
- C. Desrochers, MD;
- M. Siddharth, MD;
- B. Gerardi, CRNP;
- K. Thompson, CRNP;
- J. Michel, MD;
- A. Kelley, CRNP;
- J. Carey, RN

Editors: Clinical Pathways Team

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Poison Control Center

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Primary Care Clinical Pathway for Diagnosis and Management
of Elevated Venous Blood Lead Levels

Evidence

CHOP Programs

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Primary Care Clinical Pathway for Diagnosis and Managementof Elevated Venous Blood Lead Levels

Evidence

CHOP Programs

Media

Primary Care Clinical Pathway for Diagnosis and Management
of Elevated Venous Blood Lead Levels