the infant was unusually drowsy and hard to rouse
A 1-month-old male infant was brought into A&E by his parents and maternal grandmother. The grandmother was concerned that the infant was unusually drowsy and hard to rouse for feedings.
WHAT DO YOU WANT TO KNOW ABOUT THE PREGNANCY AND DELIVERY? WHAT QUESTIONS MIGHT BE USEFUL TO ELICIT FURTHER DETAILS SURROUNDING THE PRESENTING COMPLAINT? ARE THERE ANY RED FLAGS IN THIS HISTORY FOR NON-ACCIDENTAL INJURY?
WHAT BODY SYSTEMS WOULD YOU INCLUDE IN YOUR EXAMINATION? WHAT ARE THE PHYSICAL EXAM FINDINGS THAT WOULD BE CONSISTENT WITH NON-ACCIDENTAL INJURY? WHICH FACTORS INCREASE THE LIKELIHOOD OF A NON-ACCIDENTAL HEAD INJURY DIAGNOSIS BEING MISSED?
WHICH INVESTIGATIONS WOULD BE IMPORTANT, PARTICULARLY SINCE THE INFANT IS UNABLE TO VERBALISE INJURIES?