As emergency medicine practitioners, we see trauma on a weekly, daily and hourly basis. While there are hundreds or maybe thousands of patients that pass through our emergency department doors each day, some of the most difficult cases to treat are those of child abuse and neglect.

To be an effective advanced practitioner, you need to recognize the risk factors and warning signs of child abuse, both physical and emotional. The longer a child is abused for, the more likely the abuse will lead to serious injury, long-term negative effects or death. Therefore, it is our responsibility as acute-care specialists to recognize and report suspected child abuse.

Risk Factors

Child abuse and neglect occurs throughout our society. Never cast aside your gut feeling because of a family’s race, socioeconomic status or outward appearance.

There are, however, risk factors that increase the likelihood of child abuse and can help you recognize it when treating children in your emergency medicine practice. Child characteristics, including behavioral difficulties, chronic illness and developmental disability increase the likelihood a child is abused or neglected.

Parental and familial characteristics also play a part. Young, unmarried and/or single parents, and those who suffered abuse as a child themselves are more likely to abuse their own children. Child abuse is more common in families living in poverty and those with intimate partner violence.

Warning Signs of Child Abuse

Recognizing and acting on the warning signs of child abuse can limit the long-term effects of abuse and save lives. Take extra precaution in cases with the following characteristics:

  • Repeated use of the emergency department.
  • Injuries unusual for the accident parents describe.
  • Contradictory or changing stories from parents and/or the child.
  • Delayed admission to the emergency department, despite serious injury.
  • Old bruises, burns and lesions visible during diagnostic testing.
  • Family members other than parents accompanying child to the emergency room.

There are many scientific studies on emergency medicine practitioners’ ability to recognize the warning signs of child abuse. I encourage you to read these studies’ findings and consider them throughout your daily practice of emergency medicine.

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