Title: Child Abuse (Non-accidental Trauma)
Headings: Child Abuse (Non-accidental Trauma)
Child Abuse (Non-accidental Trauma)
Child Abuse (Non-accidental Trauma)
Background
Risk Factors
History
Physical Exam
Radiographic Imaging
Lab Testing
Injuries
Bruises
Fractures
Head Trauma
Reporting
Documentation
Outcomes
Summary
References

Content: A study of 44 children who died of child abuse showed that 19% of them were evaluated by a physician within a month of their death and 71% of those evaluations were in an ED. The ED complaints at these visits ranged from fussiness to vomiting and poor feeding. ( 14) And a 2010 study showed that nearly one-fifth of abuse-related fractures had at least 1 previous physician visit during which the abuse was missed. ( 15)
Risk Factors
Child abuse affects all races, religions and classes but it is well known that children in socioeconomically disadvantaged families are at greater risk. Compared with white, Native American, and Hispanic children, there is a significantly higher rate of maltreatment of African-American children with a higher mortality rate. ( 11)
Young children, especially those less than 1 year of age, have the highest rate of abuse and because of their smaller size they are particularly vulnerable to severe and fatal maltreatment. Any characteristic that that makes a child more difficult to care for predisposes them to maltreatment. Examples include children with chronic illnesses/special health care needs, emotional/behavioral disabilities, physical aggression/antisocial traits or physical/developmental disabilities. Premature delivery may also increase a child’s vulnerability to abuse. ( 2,16)
Parents with a limited knowledge of normal child development, low sense of parenting competence, or harsh, inattentive, or inconsistent parenting may be predisposed to abuse their children.