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Ernie brings in his son Sean, aged six years, who injured his wrist yesterday afternoon while playing soccer in the backyard with his brother Bruce, aged eight years. Sean looks distressed and is supporting his left wrist with his right hand. Sean pipes up saying Bruce had come up from behind and pushed him hard. He has been reluctant to move his wrist since.
Sean’s father has given him some paracetamol and put a support bandage on the wrist. Sean has continued to complain about the pain, so Ernie has brought him in to see you. Ernie wonders whether Sean has broken his wrist.
Note: Some of this case study is presented as dialogue between the general practitioner (GP) and the patient to assist participants to formulate their own approaches to similar presentations. Notes for GPs are included in bold parentheses. 1.What else would you like to know? 2.What are the key components that discriminate bullying from other aggressive behaviours? 3.Why do GPs need to identify and address sibling bullying? 4.What are your next steps? 5.What is your working differential diagnosis? 6.When Ernie and Laura return for the next appointment, how will you distinguish between sibling rivalry and sibling bullying? #Week11_Case5
Family and domestic abuse and violence is very common, and the children in these families will be affected. They may present with a number of issues such as difficulties at school, being withdrawn, eating disorders, anxiety, depression and being homeless.t is important to ask about the possibility of abuse and violence in the family, to use the LIVES approach and to work with safety. #IPV_children_Issues
Headspace provides mental health support services to young people aged 12 to 25 years, who are experiencing, or at risk, of mental ill-health. #Headspace
#IPV_LIVES The LIVES (Listen, Inquire, Validate, Enhance safety and Support) approach has been developed by the World Health Organization working party on intimate partner (abuse) violence (IPV or IPAV). This outlines the steps to take after someone has told you about IPV (Table 1).
