Awareness of sentinel injuries amongst Canadian paediatricians: A CPSP one-time survey
CPS ePoster Library. Barrett R. 06/22/16; 128093; 22
Dr. Rachel Barrett
Dr. Rachel Barrett
Login now to access Regular content available to all registered users.
Abstract
Rate & Comment (0)
Background: A sentinel injury is a visible or detectable minor injury in a pre-cruising infant that is poorly explained and therefore suspicious for physical abuse. Examples include bruises and intra-oral bleeding, which may be “warning injuries” for possible abuse. Timely recognition and management of a sentinel injury can potentially alter a pattern of escalating child abuse, but studies have demonstrated that in up to a third of cases, physicians miss early signs of abuse.

Objectives: Our purpose was to assess paediatrician awareness of sentinel injuries in pre-cruising children as precursors to more serious physical abuse.

Methods: A Canadian Paediatric Surveillance Program (CPSP) one-time survey of Canadian paediatricians was conducted in March of 2015 to evaluate awareness of sentinel injuries and their significance. Respondents were provided with clinical vignettes describing infants with sentinel injuries and were asked questions about their differential diagnosis and management plan. Respondents were then classified as either “aware” or “not aware” based on their responses, and a multivariable logistic regression analysis was used to identify variables most strongly correlated with awareness.

Result: The survey achieved a response rate of 23.4%. Of the 582 respondents, 65% were aware that bruises and intra-oral injuries in pre-cruising children are red flags for possible physical abuse. Respondents were more likely to be aware of bruises as sentinel injuries (91.9%) than they were of intra-oral injuries (67.2%). Paediatric subspecialists were significantly less likely than general paediatricians to be aware of sentinel injuries as red flags for later serious abuse (adjusted OR = 0.57, 95% CI 0.37–0.88, p = 0.01). Other important trends included higher awareness with more recent completion of residency, and also with additional training in the area of child abuse and neglect.

Conclusion: Over one third of Canadian paediatricians are unaware that unexplained bruising and intra-oral bleeding in a pre-cruising child should prompt assessment for possible abuse. Further physician education is warranted to ensure that paediatricians understand the importance of sentinel injuries and the indications for initiating investigations to detect occult injuries of child abuse. Future directions include the development of physician training opportunities in the area of identifying and managing sentinel injuries, as well as extending the study population to include family physicians who provide primary care to children.
Background: A sentinel injury is a visible or detectable minor injury in a pre-cruising infant that is poorly explained and therefore suspicious for physical abuse. Examples include bruises and intra-oral bleeding, which may be “warning injuries” for possible abuse. Timely recognition and management of a sentinel injury can potentially alter a pattern of escalating child abuse, but studies have demonstrated that in up to a third of cases, physicians miss early signs of abuse.

Objectives: Our purpose was to assess paediatrician awareness of sentinel injuries in pre-cruising children as precursors to more serious physical abuse.

Methods: A Canadian Paediatric Surveillance Program (CPSP) one-time survey of Canadian paediatricians was conducted in March of 2015 to evaluate awareness of sentinel injuries and their significance. Respondents were provided with clinical vignettes describing infants with sentinel injuries and were asked questions about their differential diagnosis and management plan. Respondents were then classified as either “aware” or “not aware” based on their responses, and a multivariable logistic regression analysis was used to identify variables most strongly correlated with awareness.

Result: The survey achieved a response rate of 23.4%. Of the 582 respondents, 65% were aware that bruises and intra-oral injuries in pre-cruising children are red flags for possible physical abuse. Respondents were more likely to be aware of bruises as sentinel injuries (91.9%) than they were of intra-oral injuries (67.2%). Paediatric subspecialists were significantly less likely than general paediatricians to be aware of sentinel injuries as red flags for later serious abuse (adjusted OR = 0.57, 95% CI 0.37–0.88, p = 0.01). Other important trends included higher awareness with more recent completion of residency, and also with additional training in the area of child abuse and neglect.

Conclusion: Over one third of Canadian paediatricians are unaware that unexplained bruising and intra-oral bleeding in a pre-cruising child should prompt assessment for possible abuse. Further physician education is warranted to ensure that paediatricians understand the importance of sentinel injuries and the indications for initiating investigations to detect occult injuries of child abuse. Future directions include the development of physician training opportunities in the area of identifying and managing sentinel injuries, as well as extending the study population to include family physicians who provide primary care to children.
    This eLearning portal is powered by:
    This eLearning portal is powered by MULTIEPORTAL
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.


Save Settings