Sentinel Injuries
- General exam: make sure to perform comprehensive exams of
- Mouth/oropharynx
- Skin
- Genitalia/anus
- What to look for in record review
- Newborn care (Vitamin K)
- Past injuries/accidents
- Bleeding response to vaccines/phlebotomy
- Family history of predisposition to bleeding/bruising
Accessible Version
In the last slide, I presented this patient's history and physical exam.
In this slide, I want to highlight which of the pieces of the history and physical exam are essential and are not to miss.
In terms of his exam or an exam on an infant, it's really important, especially if you've identified a potentially a sentinel injury.
To perform comprehensive exam of the body with attention to the mouth the oropharynx, the skin in its entirety, which also should include the scalp, as well as the genitalia and the anus.
On record review, I'm paying particular attention to the newborn nursery stay, including whether the child received the typical IM vitamin K injection.
To confirm that the child has the ability to clot. And not have extensive bleeding.
I'm also asking and looking in the records for any documentation of other injuries or accidents.
Their bleeding response to vaccines and phlebotomy, as well as a family history of predisposition to bleeding and bruising.
And the reason that we are looking for all these things in the record and taking this comprehensive history is we certainly don't want to diagnose abuse when there's a medical issue or an accident to be considered at least.