Paeds Cases · child-safety-and-social-paediatrics
Explain suspected poisoning as maltreatment to a parent — OSCE
OSCE communication and safeguarding station: explaining the recognition of suspected poisoning as maltreatment to a parent, why the team must investigate and keep the child in hospital, what the toxicology and separation test are for, and how the child and siblings will be kept safe — without accusation, with empathy and honesty.
On this page
Study tools
Target exams
Candidate instructions
You are the paediatric registrar. The mother of a two-year-old girl admitted for the third time with an unexplained seizing illness and a high sodium has ten minutes with you. She is frightened, watchful, and articulate. She wants to understand, in plain language: (1) why the team is doing so many blood and urine tests and what each is for; (2) why a child-protection nurse is involved and why she cannot take her daughter home today; (3) whether the doctors think she has been poisoning her child; and (4) what happens next, including her other children. Explain with empathy and honesty, do not accuse, check understanding throughout, and agree a clear plan. [1]
References4ShowHide
- [1]Rosenberg DA Web of deceit: a literature review of Munchausen syndrome by proxy Child Abuse Negl, 1987.PMID 3322516
- [2]Davis P, McClure RJ, Rolfe K, Chessman N, Pearson S, Sibert JR Procedures, placement, and risks of further abuse after Munchausen syndrome by proxy, non-accidental poisoning, and non-accidental suffocation Arch Dis Child, 1998.PMID 9613350
- [3]Bass C, Glaser D Early recognition and management of fabricated or induced illness in children Lancet, 2014.PMID 24612863
- [4]Tully J, Hopkins O, Smith A, Williams K Fabricated or induced illness in children: A guide for Australian health-care practitioners J Paediatr Child Health, 2021.PMID 34310788