Your Visit with Bryson

A local pediatrician has referred 11-month-old Bryson to the HTC for a history of multiple raised bruises without known trauma. This is his first time at our HTC, so we need to get some information from his parents first.
After learning the reason for the visit, what question might be appropriate to ask to begin the conversation?

“Well, um, my son keeps getting bruised and we can’t figure out why.”

Although it is an acceptable question to ask, this information could be found in the patient’s chart. There is a better choice among the selections provided.

“I’m not sure if I understand your question. My son wakes up with these bruises and our pediatrician can’t figure out the cause.”

This question could be taken out of context. The mother might already be apprehensive about having to explain why her child is bruised. Proceed carefully. There is a better choice among the selections provided.

“I think it’s because we can’t figure out why he keeps getting bruised. That’s why he referred us to you.”

Unless the pediatrician mentioned in his notes that he gave her reasons for the recommendation, she is giving her best speculation. There is a better choice among the selections provided.

“Not that I am aware of. I can’t recall anyone ever having any abnormal bleeding.”

Great question. Often, a child will present with bleeding from circumcision or, as in this case, multiple raised bruises without known trauma. Although there appears to be no family history of hemophilia, we shouldn’t rule it out just yet.
