title: Effect of a screening profile on the diagnosis of nonaccidental burns in children.
abstract: OBJECTIVE
  To determine if awareness of factors associated with burn abuse increases recognition and reporting by emergency physicians.
  
  
  METHODS
  The study consisted of a retrospective chart review and a subsequent intervention.
  
  
  METHODS
  An urban pediatric emergency department (ED).
  
  
  METHODS
  All patients with the diagnosis of burn seen in the ED.
  
  
  METHODS
  The retrospective chart review (October 1, 1990, to September 30, 1991) determined the number of patients seen in the ED, diagnosed with burns, and reported to the department of social service. We then determined whether or not the department of social service, after completion of their investigation, "verified" that abuse had occurred. In addition, other services provided to the family by the department of social services were determined. The prospective study (April 1, 1992, to March 30, 1993) introduced a checklist of 13 factors associated with abusive burns into the history and physical examination of all burn victims presenting to the ED. Changes in overall referrals to the department of social service as well as in the numbers of cases in which abuse were verified or services offered were then determined.
  
  
  RESULTS
  Prior to any intervention, 3% (3/87) of burns presenting to the ED from 1990 to 1991 were reported to the department of social service. This contrasted with 12.1% (26/215) of burns presenting after introduction of the checklist. Burn victims, 1/87 (1%), in the retrospective study and 16/215 (7.4%) burn victims in the prospective study received social service intervention after a report was initiated by the ED staff (P < .002). Burn injuries 1/87 (1%) and 7/215 (3.3%), reported during the two studies were substantiated as abusive by social services.
  
  
  CONCLUSIONS
  We conclude that the use of the checklist increased effective social service referral for burn abuse.
authors.affiliation: Emergency Department, Children's Hospital of Denver, CO 80218, USA.
authors.forename: K D
authors.initials: KD
authors.lastname: Clark
authors.forename: D
authors.initials: D
authors.lastname: Tepper
authors.forename: C
authors.initials: C
authors.lastname: Jenny
mesh_terms: D000293:Adolescent; D002056:Burns / Q000145:classification / Q000209:etiology*; D002648:Child; D002649:Child Abuse / Q000175:diagnosis*; D002675:Child, Preschool; D003120:Colorado; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019221:Mandatory Reporting; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors