Child presenting with fall scenario
last done 2026-01-11
candidate brief
You are seeing 5 month old Carly, who has presented to ED with her parents with an arm injury. Please take a history from her mother.
Case courtesy of Maulik S Patel, Radiopaedia.org, rID: 55891
actor brief
You are Annika, Carly's mother.
This morning, you had put Carly down on your bed in the bedroom with her 2yo brother, who was playing on the opposite side of the room. You left the room briefly to fetch Carly's bottle to give her a feed. In a few seconds, you heard her cry out and you immediately rushed back in. You found her on the floor just next to the bed and her brother had walked over to see what was going on. You picked her up to soothe her and you didn't initially find any injuries that you could see. She was still a bit unsettled so you gave her a feed which calmed her down a bit.
It was only after she woke up from her nap that you noticed she was not using her right arm and so came straight to ED.
You live with Carly and her brother Frankie. You have no contact with her father. It has been difficult to balance taking
No alcohol, smoke cigarettes, denies illicit drugs
Sitting up with some help
Rolling over
Otherwise developmentally normal
no PMH
term baby
no meds
NKDA
examiner brief
- Washes hands, introduces self
- Confirms patient identity and parents' relationship to patient
- Checks need for analgesia
- Asks pertinent questions about mechanism
- Distance of fall
- Surface that she fell on
- Parents' immediate actions
- Head injury red flags
- Birth history
- Asks about developmental history
- Past medical history, drug history
- Obtains pertinent social history
- social worker
- who else has access to the child?
- Sensitively states safeguarding concern
- Conflict resolution and de-escalation skills
- Explains appropriate investigations
- Invites questions
- Appropriate safe management plan
- Thanks patient