Bleeding and brusing in children: Formulating your response (CME)


CME article on determining when a bruise on a child is possible abuse, and when it may be due to bleeding diathesis.


Accreditation cme2 is accredited by the ACCME to provide continuing medical education for physicians.

Target audience: Pediatricians and primary care physicians

To earn CME credit for this activity Participants should study the article and log on to, and click on the "Earn CME Credit" button on the left-hand side. Participants must pass a post-test and complete an online evaluation of the CME activity. After passing the post-test and completing the online evaluation, a CME certificate will be e-mailed to them. The release date for this activity is June 1, 2009. The expiration date is June 1, 2010.

Disclosures Editors Toby Hindin, Jeannette Mallozzi, and Jeff Ryan disclose that they do not have any financial relationships with any manufacturer in this area of medicine.

Manuscript reviewers disclose that they do not have any financial relationships with any manufacturer in this area of medicine.

DR. SAVAGE is an Assistant Professor in the Departments of Transfusion Medicine and Department of Pediatric Hematology, Johns Hopkins School of Medicine, Baltimore.

DR. TAKEMOTO is an Assistant Professor in the Department of Pediatric Hematology, Johns Hopkins School of Medicine.

The authors have nothing to disclose with regard to affiliations with, or financial interest in, any organization that may have an interest in any part of this article.

Resolution of conflict of interest cme2 has implemented a process to resolve conflicts of interest for each continuing medical education activity, to help ensure content validity, independence, fair balance, and that the content is aligned with the interest of the public. Conflicts, if any, are resolved through a peer review process.

Unapproved/off-label use discussion Faculty may discuss information about pharmaceutical agents, devices, or diagnostic products that are outside of FDA-approved labeling. This information is intended solely for CME and is not intended to promote off-label use of these medications. If you have questions, contact the medical affairs department of the manufacturer for the most recent prescribing information. Faculty are required to disclose any off-label discussion.

When you do decide to pursue a child's bleeding, a thorough history with focused questions pertinent to bleeding and a physical exam combined with screening tests are basic tenets of the initial workup.

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