[Correlations between pediatric emergency department and legal medicine in the field of child abuse: the usefulness of flow-charts].
According to the World Health Organization, child abuse is one of the major and unrecognised problems affecting the well-being and impairing the harmonic development of children and adolescents. Official statistics, provided by Police and Courts are not useful for quantifying abuse because these numbers refer to cases actually brought to trial, a small part of the amount. In Europe and North America more effective measures and intervention programs were set up in order to get with a reliable description of this crucial social problem; for example, a "dedicated" team performing careful screenings on suspicious cases (Suspected Child Abuse and Neglect Teams, SCAN). A legal medical expert joins the team bringing his specific experience on lesions from the perspective of criminological interpretation, thereby giving a substantial contribution for an objective evaluation of available evidence. The multidisciplinary approach can give the greatest contribution especially in the initial steps of the evaluation of the child. Intervention protocols and guidelines are useful tools to achieve this goal, as shown by medical literature. We propose to introduce a flow-chart for the initial evaluation of cases, derived from that used in the Canadian Paediatric Emergency Departments. This is supposed to be experimentally used by health care workers in an Emergency Department setting and to be subsequently evaluated both as a diagnostic and a statistic instrument.
Zaglia
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Department of Public Health, Division of Legal Medicine, University of Verona.
Dall'Agnola
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Marigo
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De Leo
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D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000175:diagnosis*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005554:Forensic Medicine / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D007558:Italy; D010372:Pediatrics / Q000458:organization & administration*; D012042:Registries; D012985:Software Design