Thursday, June 22, 2017

Image of the Month (From August/September 2011 Issue of Modern Resident)

Author: Casey Grover, MD
Stanford/Kaiser Emergency Medicine
Originally Published: Modern Resident, August/September 2011

A 17 month old female is brought to the ED by her mother for emesis and fever. The mother thinks that her daughter may have swallowed something last night because the child had made a "wheezing sound" while breathing and appeared uncomfortable. There was no witnessed ingestion. The child appears well with normal vital signs and is playful and interactive. Her physical exam, including pulmonary examination, is normal.

You order a PA and lateral chest X-ray. What does it show?

 
Image Credit: Modern Resident
  1. A coin in the esophagus
  2. A coin in the trachea
  3. A bottle cap in the esophagus
  4. A button battery in the esophagus
Click here for the answer.

Sunday, June 18, 2017

Tell Me More: The Basics of Child Forensic Interviewing

Image Credit: Pixabay
This post was peer reviewed.
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Author: Michelle Mitchell, MD, PGY-1
Duke University Medical Center

Posterior rib fractures in infants. Burns on the buttocks and legs. Mechanism of injury that is not consistent with developmental age. Most physicians will recognize these potential red flags of child abuse. However, many emergency medicine physicians have received little training on how to interview children who present with injuries concerning for child abuse. As physicians, we are not expected to definitively determine if child abuse has occurred. Instead, we often report suspected cases and leave the investigation to the authorities. It is thus important to obtain and document a thorough history in the medical record as it may be used in future court proceedings.

It is imperative that physicians have general knowledge about forensic child interviewing, as the method of interviewing may greatly impact the information that a child provides. Most models of child forensic interviewing have three stages.