Citation

Tingberg B, Falk AC, Flodmark O, Ygge BM. Acta Paediatr. 2009; 98(5): 777-781.

Affiliation

Astrid Lindgren Children's Hospital, Karolinska Institutet, Department of Woman and Child Health, Stockholm, Sweden. bjorn.tingberg@karolinska.se

Copyright

(Copyright © 2009, John Wiley and Sons)

DOI

10.1111/j.1651-2227.2009.01241.x

PMID

19389121

Abstract

AIM: The aim is to evaluate medical record documentation regarding potential abusive head injury (AHI) in infants presenting to a Paediatric Emergency Department (ED) with certain primary complaints known to be associated with AHI. METHODS: A database search was performed to find all medical records over a period of one year relating to those children who had one AHI-related primary complaint and who had had a CT head-scan performed in conjunction with admission. Each medical record was reviewed, in order to assess whether potential abuse had been investigated and documented. Each CT-scan image was re-evaluated for missed indications of potential injuries attributable to AHI. RESULTS: Forty-seven such medical records were found. Of these, 87% showed the diagnosis to be head injuries. The largest group of children was in the age group 0-3 months (38%). Of the children admitted to the Paediatric ED due to a head injury, 54% had a history deemed to raise suspicions of abuse but only five of them had had a documented investigation of child abuse. The re-evaluation of the CT-scans showed no missed cases. CONCLUSION: In this study we found that among children with known risk factors for AHI, only a few had documentation regarding potential child abuse. The use of a standardized protocol could be helpful in the important work to help staff discover potential AHI.

Language: en