The diagnosis and evaluation of child maltreatment.
Child maltreatment continues to be one of the most common and most difficult problems seen in the emergency room. An early estimate indicated that up to 10% of children under age 6 seen in emergency departments have some form of nonaccidental injury. Recent data suggest that approximately 1% of the child population are victims of maltreatment each year. Many of these cases involve only subtle signs and have great potential to pass undetected. This article provides a review of the various forms of maltreatment, with emphasis on the key points involved in the history, physical examination, and management. The protocol for evaluating maltreatment from the North Carolina Memorial Hospital is presented. This framework will aid the physician in the crucial first step of identifying maltreatment, which, along with diligent follow-up and the assistance of the available social services, offers the best hope for further prevention.
D001842:Bone and Bones / Q000293:injuries; D002056:Burns / Q000175:diagnosis / Q000209:etiology; D002648:Child; D002649:Child Abuse / Q000331:legislation & jurisprudence / Q000517:prevention & control; D019411:Clinical Laboratory Techniques; D006259:Craniocerebral Trauma / Q000175:diagnosis; D004064:Digestive System / Q000293:injuries; D006233:Persons with Disabilities; D006801:Humans; D008607:Intellectual Disability; D008487:Medical History Taking / Q000379:methods; D010290:Parents / Q000523:psychology; D010808:Physical Examination; D010819:Physician's Role; D012306:Risk; D012742:Sex Offenses; D012931:Social Environment; D013398:Sudden Infant Death / Q000175:diagnosis / Q000209:etiology; D014566:Urogenital System / Q000293:injuries