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: 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. Rates of child maltreatment by unemployed parents are 2 to 3 times higher and substance abuse and mental illness are also more common. ( 11) Factors that decrease a parent’s ability to cope with stress increase the potential for maltreatment including: low self-esteem, poor impulse control, young age, low educational achievement, poor social support and mental illness. In addition, parents who were victims of child maltreatment themselves or who currently have an abusive partner are more likely to be abusive parents. ( 2)
History
As front-line providers, it is the role of emergency physician to maintain a high index of suspicion with every pediatric patient encounter because the clues to diagnose maltreatment may be very subtle.