Delays in care seeking for young children with accidental skull fractures are common.
accidental head injuries
child abuse
delays in medical care
infants and toddlers
skull fractures
Journal
Acta paediatrica (Oslo, Norway : 1992)
ISSN: 1651-2227
Titre abrégé: Acta Paediatr
Pays: Norway
ID NLM: 9205968
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
revised:
02
11
2020
received:
20
04
2020
accepted:
05
11
2020
pubmed:
12
11
2020
medline:
9
6
2021
entrez:
11
11
2020
Statut:
ppublish
Résumé
We sought to determine the frequency and patterns of delayed medical care seeking for young children with skull fractures. We identified accidental skull fractures <4 years old, 2011-2012. Child abuse paediatricians abstracted retrospective data and paediatric radiologists re-reviewed images. 'Delays' were defined as presentation at ≥6 h. 'Minor accidents' included falls <4 feet and low force trauma, while 'major accidents' included higher height falls and major force events. We studied the frequency and duration of care delays, the signs or symptoms leading to care, and the duration of delays after signs or symptoms developed. Two hundred and ten children had accidental skull fractures. Delays were less likely with major accidents (4.9%), than with minor accidents (25.8%) (RR = 0.32 [0.15-0.70]). Children came to care for scalp swelling (STS) (39%), the injury event (36.2%), altered consciousness (15.2%) and vomiting (10.5%). Delayed onset of STS (78.6%) caused most delayed care. Early STS was firm, (17.6%) versus delayed (5.0%), as opposed to soft or fluctuant. Delayed care seeking is common for minor, but not major accidental infant and toddler skull fractures. Most followed delayed onset of signs and symptoms. Delayed care seeking alone should not imply child abuse.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1890-1894Informations de copyright
© 2020 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
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