Case Scenario Kyle Explained for Students (Easy Guide)
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Original Question
Case Scenario: Kyle is a 5yr boy who presents in the emergency department with his mother. Kyle was diagnosed with autism when he was 3yrs old and has limited language. Mom stated that while visiting with his father it was reported the child slipped while running on hardwood flooring and hit his head. Mom reports that he was a bit dazed and had one incident of vomiting while driving home. The nurse attempts to examine Kyle, but he is irritable, pulling at his hair, and hitting his head with his hands. Mom does her best to redirect and distract but struggles holding him during the physical assessment. Later, a head CT reveals a depressed temporal skull fracture. There is also evidence of three other older linear fractures, two of which cross a suture lines. There are no available records for emergency department visits for those fractures, but a recent chest x-ray shows an incidental finding of three healing rib fractures. When asked, the mom seem to be unsure what could have caused the previous fractures, suggesting “maybe they are from rough housing with his father or maybe playing with friends at school.” Mom is very upset and cries stating that she does the best she could to care for her son. She is often alone caring for Kyle and works long hours. Kyle’s father only takes him every other weekend. The doctor explains he is very concerned as he suspects abuse and will be consulting with child protective service as a story like this does not fit the severity of the injury. Children with disabilities are recognized as a population at increased risk for maltreatment. Address this statement as it applies to Kyle and his family.
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