Vulnerable child syndrome

Mitchell M, Blackburn M. “What We’ve Got Here Is Failure to Communicate”: The Value of Reassurance. Hosp Pediatr. 2016 Jun;6(6):380-2.

“The hospitalist team, with assistance from our infectious disease and forensic pediatric experts, ultimately diagnosed this patient with vulnerable child syndrome. [1] The family was given a set of distinct instructions regarding the patient’s medical care, including discontinuation of lansoprazole, erythromycin, and bethanechol. The family was also instructed to abstain from taking any temperatures at home and provided with information on normal childhood illness patterns. They were agreeable to this plan of care and were given reassurance regarding the benign nature of common childhood viral illnesses, which may be accompanied by fever, along with the benign nature of fever itself. The child’s pediatrician was also given a copy of the plan and agreed to assist in providing reassurance to this family.”

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Chambers PL, et al. Vulnerable child syndrome, parental perception of child vulnerability, and emergency department usage. Pediatr Emerg Care. 2011 Nov; 27(11):1009-13.

“Despite…limitations, the implications of our investigation are important. This study revealed that children who have high PPCV had an increased number of ED visits for minor illnesses. If health care practitioners working in the ED take a few extra minutes to identify families at risk and preemptively take measures to address anxiety and promote healthy family dynamics,18 including extra time and care to assess parental expectations and anxiety15 at the first ED visit, the overall number of ED visits for these families may be decreased, and patient satisfaction may increase. Future investigation of the role of VCS in other ED settings and the development of educational and preventive interventions in families with the dynamics of VCS are warranted in the current family-centered and cost-conscious health care climate.”

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Kokotos F. The vulnerable child syndrome. Pediatr Rev. 2009 May;30(5):193-4.

“Particular risk factors for VCS include a child who has a history of serious illness or injury; who is “symbolic” for the parent of a significant person who died prematurely or unexpectedly; whose life or whose mother’s life was at risk during pregnancy or delivery; who a physician said might die; and whose mother has a history of threatened abortion, multiple spontaneous abortions or stillbirths, or fertility issues. A mother’s perception of her child’s vulnerability can be exacerbated by environmental stress, family stress, lack of social support, low socioeconomic status, and poor rating of her own health.”

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Pearson SR, Boyce WT. Consultation with the specialist: the vulnerable child syndrome. Pediatr Rev. 2004 Oct;25(10):345-9.

After completing this article, readers should be able to:

  1. Describe the vulnerable child syndrome (VCS).
  2. Discuss the risk factors for VCS.
  3. Identify the clinical hallmarks of VCS.
  4. Discuss how to preempt the development of VCS.

Full-text for Children’s and Emory users.

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