documenting burns

Published

Specializes in nicu, internal medicine.

:confused:How do we document what we think is a cigarrette burn? The child couldn't tell me what it was a burn, a rash she scratched . It is between thumb and index finger. She thought it was maybe from hot soup but wasn't sure. Family does have hx w CPS. This is my first yr as school nurse and need help with this one please.

Up Vote Up Vote ×
Specializes in school nursing, ortho, trauma.

How old is the child? Old enough to relay an intentional cigarette burn event to you? Is the child acting evasive?

Do you have another set of eyes that can help you id the mark, like maybe a guidance counselor or social worker?

When a child has a known history with CPS though and especially if i notice any other marks, it may be worth while to call them to inform them. Especially if you really feel strongly that it is a cigarette burn and is not accidental or is paired with other suspicious injuries.

Sometimes if I am really not sure i will bite the bullet and make a quick call home to see if the parent had noticed the injury. I keep my questions vague and short and don't ask anything leading. I'd probably say "Did you notice the mark on Sally's hand?" and let them lead the conversation.

Up Vote Up Vote ×
Specializes in nicu, internal medicine.

these kids have learned what to answer to "protect" mom. Sally is 2nd grade,smart little girl. They bounce back from grma to mother all the time. When IAM able to get a hold of mom she sounds "sleepy/groggy, slurred speech" if you know what I mean.

Up Vote Up Vote ×
Specializes in school nursing, ortho, trauma.

then i'd call CPS if i felt it was a cigarette burn if that were the case.

Up Vote Up Vote ×
Specializes in School Nursing, Ambulatory Care, etc..

Remember, it is CPS's job to investagate not ours. We are bound by duty and law to report anything we suspect may be signs of abuse

Up Vote Up Vote ×

You are bound by law to CALL IN & REPORT any suspected sign of abuse. It's CPS's job to investigate it.

Up Vote Up Vote ×
Specializes in nicu, internal medicine.

I did report it of course/ Thank you Flare for suggesting a second pair of eyes (school counselor) confirm the wound. It's not these poor kids fault they end up w/ less the family life they have.

Thank you all for your advice

school nurse in training =)

Up Vote Up Vote ×
Specializes in PICU, NICU, L&D, Public Health, Hospice.

My experience has taught me that you were correct to report....was likely a cigarette burn but, dependent upon age of child, may have been self inflicted. Some kids growing up in abusive homes experiment with self injury and mutilation...

Up Vote Up Vote ×
+ Join the Discussion