Paeds Cases · child-safety-and-social-paediatrics
Explain suspected abusive head trauma to a frightened parent — OSCE
OSCE communication and shared-planning station: explaining the recognition of suspected abusive head trauma to a parent, the workup and safeguarding process, why the team must investigate, and how the child will be kept safe — without accusation, with empathy and honesty.
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You are the paediatric registrar. The mother of a four-month-old boy admitted with encephalopathy and a subdural bleed has ten minutes with you. She is frightened and tearful. She wants to understand, in plain language: (1) why the team is arranging so many tests and what each is for; (2) why a child-protection team is involved and why she cannot take him home today; (3) whether the doctors think she has hurt her baby; and (4) what happens next. Explain with empathy and honesty, do not accuse, check understanding throughout, and agree a clear plan. [1]
References4ShowHide
- [1]Narang SK, Fingarson A, Lukefahr J, et al. Abusive Head Trauma in Infants and Children. Pediatrics, 2020.PMID 32205464
- [2]Maguire SA, Kemp AM, Lumb RC, et al. Estimating the probability of abusive head trauma: a pooled analysis. Pediatrics, 2011.PMID 21844052
- [3]Lindberg DM, Shapiro RA, Blood EA, et al. Prevalence of abusive injuries in siblings and household contacts of physically abused children. Pediatrics, 2012.PMID 22778300
- [4]Debelle GD, Maguire S, Watts P, et al. Abusive head trauma and the triad: a critique on behalf of RCPCH of 'Traumatic shaking: the role of the triad in medical investigations of suspected traumatic shaking'. Arch Dis Child, 2018.PMID 29510999