Screening for Child Abuse in Children With Isolated Skull Fractures.
Pediatr Emerg Care
; 39(6): 374-377, 2023 Jun 01.
Article
em En
| MEDLINE
| ID: mdl-36018728
ABSTRACT
OBJECTIVE:
Head trauma is the most common cause of death from child abuse, and each encounter for recurrent abuse is associated with greater morbidity. Isolated skull fractures (ISF) are often treated conservatively in the emergency department (ED). We determined patterns of physical abuse screening in a children's hospital ED for children with ISF.METHODS:
A retrospective review was performed for children aged 3 years and younger who presented to the ED with ISF from January 1, 2015 to December 31, 2019. Children were stratified by age (<12 mo, ≥12 mo) and witnessed versus unwitnessed injury. Primary outcome was social work (SW) assessment to prescreen for abuse. Secondary outcomes were suspicion for abuse based on Child Protective Services (CPS) referral and subsequent ED encounters within 1 year.RESULTS:
Sixty-six ISF patients were identified. Of unwitnessed injury patients aged younger than 12 months (n = 17/22), 88.2% (n = 15/17) underwent SW assessment and 47.1% (n = 8/17) required CPS referral. Of witnessed injury patients aged younger than 12 months (n = 23/44), 60.9% (n = 14/23) underwent SW assessment, with no CPS referrals. Overall, 18.2% (n = 4/22) unwitnessed and 20.5% (n = 9/44) witnessed injury patients returned to our ED 2 were aged younger than 12 months and had recurrent trauma.CONCLUSIONS:
To decrease risk of missed physical abuse, SW consultation should be considered for all ISF patients.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fraturas Cranianas
/
Maus-Tratos Infantis
/
Traumatismos Craniocerebrais
Tipo de estudo:
Diagnostic_studies
/
Screening_studies
Limite:
Child
/
Humans
/
Infant
Idioma:
En
Revista:
Pediatr Emerg Care
Assunto da revista:
MEDICINA DE EMERGENCIA
/
PEDIATRIA
Ano de publicação:
2023
Tipo de documento:
Article