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Case Study #2:

You are on rotation at a major children's burn center, and are asked to evaluate a 19 month old boy who was recently transferred to the center from a hospital in another city. The parents tell you that when they were not looking, the child slipped into the bathroom, turned on the hot water, and climbed into the tub. Upon reading the transfer records, you note the parents gave a history at the other hospital that a 3 year old sibling may have turned on the water and pushed the child into the tub. The sibling was not injured. You also note the parents did not seek medical attention for the child until eight hours after the burn, when a relative heard the child crying and took the child to the hospital against the parents' wishes.

On examination, you notice full-thickness burns to the buttocks, perineum, and lower legs, but no burns to the knees, arms, face, or trunk.

Figs. 16, 17 & 18: Full thickness scald burns in a 19 month old.

Is the parents' explanation consistent with the physical findings? Explain your answer.

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Are the physical findings more consistent with inflicted injury or with accidental injury? Explain your answer.

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