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15分钟会诊:儿童烧伤:故意伤害、疏忽或意外所致。

Fifteen-minute consultation: Childhood burns: inflicted, neglect or accidental.

作者信息

Mullen Stephen, Begley Roisin, Roberts Zoe, Kemp Alison Mary

机构信息

Paediatric Emergency Department, Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland.

Paediatric Emergency Department, University Hospital of Wales, Cardiff, UK.

出版信息

Arch Dis Child Educ Pract Ed. 2019 Apr;104(2):74-78. doi: 10.1136/archdischild-2018-315167. Epub 2018 Jun 22.

Abstract

Burns are a relatively common injury in children accounting for over 50 000 emergency department attendances each year. An estimated 1 in 10 of these are due to maltreatment. These may present in the form of physical abuse or neglect with a reported ratio of 1:9. A burn associated with maltreatment may be a marker for future abuse or neglect and it is paramount that concerns are identified and addressed at the initial visit. Paediatricians need to be confident to identify safeguarding concerns specific to childhood burns and investigate accordingly. In this review, key variables that may aid in differentiating maltreatment from accidental burns are discussed in a case-based format, utilising up-to-date evidence to support the recommendations. Despite a proportion of burns resulting from physical abuse, the rate of child protection investigations in these patients are significantly lower than for children who present with other forms of physical injuries despite a similar proportion of positive findings. Our objective is to review the available evidence to support the safe assessment and management of children presenting with scalds or contact burns.

摘要

烧伤在儿童中是一种较为常见的损伤,每年有超过50000例患儿前往急诊科就诊。据估计,其中十分之一的烧伤是由虐待所致。这些烧伤可能表现为身体虐待或忽视,报告的比例为1:9。与虐待相关的烧伤可能是未来遭受虐待或忽视的一个迹象,在初次就诊时识别并解决这些问题至关重要。儿科医生需要有信心识别出儿童烧伤特有的安全问题并进行相应调查。在本综述中,以病例为基础的形式讨论了可能有助于区分虐待性烧伤和意外烧伤的关键变量,并利用最新证据来支持这些建议。尽管有一部分烧伤是由身体虐待造成的,但这些患者的儿童保护调查率显著低于出现其他形式身体损伤的儿童,尽管阳性结果的比例相似。我们的目的是回顾现有证据,以支持对出现烫伤或接触性烧伤的儿童进行安全评估和管理。

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