title: Educational paper: Detection of child abuse and neglect at the emergency room.
abstract: The emergency room (ER) represents the main system entry for crises-based health care visits. It is estimated that 2% to 10% of children visiting the ER are victims of child abuse and neglect (CAN). Therefore, ER personnel may be the first hospital contact and opportunity for CAN victims to be recognised. Early diagnosis of CAN is important, as without early identification and intervention, about one in three children will suffer subsequent abuse. This educational paper provides the reader with an up-to-date and in-depth overview of the current screening methods for CAN at the ER.
  
  
  CONCLUSIONS
  We believe that a combined approach, using a checklist with risk factors for CAN, a structured clinical assessment and inspection of the undressed patient (called 'top-toe' inspection) and a system of standard referral of all children from parents who attend the ER because of alcohol or drugs intoxication, severe psychiatric disorders or with injuries due to intimate partner violence, is the most promising procedure for the early diagnosis of CAN in the ER setting.
authors: Department of Social Paediatrics, Emma Children's Hospital, Academic Medical Centre, P.O. Box 22660, 1100, DD, Amsterdam, the Netherlands. a.h.teeuw@amc.nl
authors: Arianne Hélène
authors: AH
authors: Teeuw
authors: Bert H F
authors: BH
authors: Derkx
authors: Willeke A
authors: WA
authors: Koster
authors: Rick R
authors: RR
authors: van Rijn
mesh_terms: D057189:Checklist; D002648:Child; D002649:Child Abuse / Q000175:diagnosis*; D002669:Child Welfare; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D010808:Physical Examination; D011247:Pregnancy; D011248:Pregnancy Complications; D012017:Referral and Consultation; D012307:Risk Factors; D013179:Spouse Abuse; D019966:Substance-Related Disorders