Pediatric Non-Accidental Trauma

According to the US Department of Health and Human Services, in 2018, there were 7.8 million children evaluated nationally for child abuse. About 1700 of the cases were associated with fatalities. Did you know that the younger the child, the more likely for abuse to result in death?  For this reason, it is the responsibility of the entire healthcare team and anyone who works with children to know what the signs of child abuse are. Dr. Kevin Allen, a Pediatric Emergency Physician and Medical Director of the Child Protection Team, joins Resident Dr. Chaitanya Sambangi and Medical Student Clara Horner to discuss non-accidental trauma, including covering the following:

• Understand the epidemiology surrounding non-accidental trauma.
• Recognize common red flags in the history that would indicate concern for child abuse.
• Identify physical exam features that would raise suspicion for NAT
• Recognize potential mimics of non-accidental trauma in children.
• Select appropriate labs and imaging when NAT is suspected.
• Understand the role and responsibilities of a mandated reporter.
• Understand what happens after suspected NAT is reported.
• Identify how the COVID-19 pandemic may be impacting NAT.
• Recognize methods for pediatricians to help prevent maltreatment.

FREE CME Credit (requires sign-in):  https://mcg.cloud-cme.com/course/courseoverview?P=0&EID=11405  

Thank you for listening to this episode from the Department of Pediatrics at the Medical College of Georgia. An additional thanks to Dr. Lorna Bell, Dr. George Hsu, and Dr. Rebecca Yang who provided editing and peer review of today’s discussion.

If you have any comments, suggestions, or feedback- you can email us at mcgpediatricpodcast@augusta.edu

Remember that all content during this episode is intended for educational purposes only. It should not be used as medical advice to diagnose or treat any particular patient. Clinical vignette cases presented are based on hypothetical patient scenarios. Thank you for your support!

References:

1. https://www.acepnow.com/article/spotting-and-reporting-child-neglect-cases/?singlepage=1
2. Pierce MC, Kaczor K, Lorenz DJ, et al. Validation of a Clinical Decision Rule to Predict Abuse in Young Children Based on Bruising Characteristics. JAMA Netw Open. 2021;4(4):e215832. doi:10.1001/jamanetworkopen.2021.5832
3. Letson  MM, Cooper  JN, Deans  KJ,  et al.  Prior opportunities to identify abuse in children with abusive head trauma.   Child Abuse Negl. 2016;60:36-45. doi:10.1016/j.chiabu.2016.09.001
4. https://www.aap.org/en/patient-care/child-abuse-and-neglect/  (Policy statements/resources)
5. https://www.ncedsv.org/resources/healthcare-toolkit/pediatric-health-resources/
6.https://www.aacap.org/aacap/Families_and_Youth/Resource_Centers/Child_Abuse_Resource_Center/Home.aspx
7. https://www.caresnw.org/national-resources/
8. Other resources- Rape Crisis- https://www.rainn.org/state-resources