CHAMP Education for Child Abuse Medical Providers

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One of our objectives was to show you how sentinel injuries are identified. The first most common way that sentinel injuries are identified are on physical exam. So a child presents for a well child check. It's a four-month-old baby. The baby has a bruise on their abdomen. The clinician identifies the bruise, recognizes it as being medically minor but suspicious for physical abuse, that would be the most common way that a sentinel injury is identified. It could also look like a child who went to the emergency department for flu-like symptoms and the clinician identified a patterned injury on the child. Sometimes the caregiver may give you a history to explain the injury. Sometimes they don't. This means that the child may have been harmed and or is at risk for future harm. The other things I'll point out is that sometimes we identify sentinel injuries on chart review or by review of systems by the caregiver. Meaning the child looks well. During the clinical visit. But when asking a review of systems about anything else that's going on with the child's body, the parent says, oh, yes, I was concerned last week when he had a bruise on his ear. Her child is two years old. This would be considered a sentinel injury, even though it wasn't present on the physical exam at the time of the visit.