Inadequate history as a barrier to immunization

Article Abstract:

The inability to obtain an immunization history may be one reason inner-city children are underimmunized. Health care providers commonly do not immunize children without knowing if it is needed. Researchers attempted to ascertain the immunization status for 95 new patients at a Seattle pediatric clinic serving low-income, inner-city children. Only 21 caregivers (22%) brought immunization records. The status of five more children (5%) was ascertained by a telephone call during the visit. For the remaining 69 children (73%), 9 caregivers said records were in two locations, 18 said records were out of state, and 13 did not know where records were. Through phone calls to doctors, hospitals, schools, and daycare centers, records were eventually obtained for all but 10 children. These children were assumed to be unimmunized. Caregivers erroneously reported immunizations as being up to date in one-third of cases. Overall, excluding children with contraindications, nearly one-third of the children did not get needed immunizations.

Evaluation, Reports, Medical history taking, Immunization of children, Immunization

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Inflicted submersion in childhood

Article Abstract:

Several characteristics may help health care providers distinguish between accidental and intentional drowning in children. Researchers analyzed the medical records of 205 childhood drownings in a large metropolitan area that occurred between 1983 and 1991. They determined that 8% (16 of 205) of the drownings were intentional based on physical evidence of abuse and inconsistencies in the physical evidence or in the re-telling of the drowning event. There was physical evidence of abuse in 69% of these 16 drownings. Most of the intentional drownings (56%) happened in the bathtub. Intentional drowning victims were more likely to be a boy, to be the youngest child in their family, and to not be resuscitated. Marital status of the child's guardian, race, socioeconomic status, or history of drug or alcohol abuse were not significant factors in whether the child drowned accidentally or intentionally. The medical examiner classified only two of these drownings as intentional.

Case studies, Drowning

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Bruises in Infants and Toddlers

Article Abstract:

Bruises in children not yet walking, or on the trunk, hands, or buttocks, may indicate abuse or illness rather than accidental injury. Researchers looked for bruises on 973 children under age 3 during well-child doctor visits. Bruises were found on 21% of children. Half of walking children had bruises, while only 2% of those not yet crawling were bruised. In children under 9 months of age, bruises are uncommon and may require further investigation. Bruises were commonly on the legs and forehead, but rarely on the face. White children were much more likely to be bruised than black children.

United States, Injuries, Diagnosis, Pediatric injuries, Wounds and injuries

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