@article{ref1,
title="Providers' ability to identify sentinel injuries concerning for physical abuse in infants",
journal="Pediatric emergency care",
year="2018",
author="Eismann, Emily A. and Shapiro, Robert A. and Thackeray, Jonathan and Makoroff, Kathi and Bressler, Colleen J. and Kim, Grace J. and Vavul-Roediger, Lori and McPherson, Paul and Izsak, Eugene and Spencer, Sandra P.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVES: The objectives of this study were to assess the ability of pediatric health care providers and social workers to recognize sentinel injuries in infants under 6 months of age and to determine what factors influence their decision to evaluate for physical abuse. <br><br>METHODS: A statewide collaborative focused on sentinel injuries administered a survey to pediatric health care providers and social workers in the emergency department, urgent care, and primary care. The survey contained 8 case scenarios of infants under 6 months of age with an injury, and respondents were asked if they would consider the injury to be a sentinel injury requiring a physical abuse evaluation. Respondents were then presented with several factors and asked how much each influences the decision to perform a physical abuse evaluation. <br><br>RESULTS: A total of 565 providers completed the survey. Providers had moderate interrater reliability on their classification of the cases as sentinel injuries or not (κ = 0.57). Nearly all respondents (97%) recognized genital bruising as a sentinel injury, whereas 77% of respondents recognized intraoral injuries. Agreement was highest among social workers (κ = 0.76) and physicians with categorical pediatrics training and pediatric emergency medicine fellowship (κ = 0.63) and lowest among nurse practitioners (κ = 0.48) and residents (κ = 0.51). Concern over missing the diagnosis of abuse had the greatest influence on the decision to perform a physical abuse evaluation. <br><br>CONCLUSIONS: Sentinel injuries are not uniformly recognized as potential signs of child abuse requiring further evaluation by pediatric health care providers. Additional evidence and education are needed regarding sentinel injuries.<p /> <p>Language: en</p>",
language="en",
issn="0749-5161",
doi="10.1097/PEC.0000000000001574",
url="http://dx.doi.org/10.1097/PEC.0000000000001574"
}