title: Child abuse pediatric consults in the pediatric emergency department improve adherence to hospital guidelines.
abstract: BACKGROUND
  Little data describes the role of child abuse pediatricians in consultation for physical abuse patients the pediatric emergency department.
  
  
  OBJECTIVE
  To compare adherence in the emergency department to hospital physical abuse guidelines and need to return for testing between 2 groups: those receiving a child abuse consultation in the pediatric emergency department vs those who received standard emergency department care with subsequent child abuse review.
  
  
  METHODS
  We reviewed 471 records of visits to the pediatric emergency department for physical abuse. Data collected included demographics, studies performed, whether patients need to return after child abuse review, child abuse subpoenas, child abuse testimony in court.
  
  
  RESULTS
  Patients who received a child abuse consult in the emergency department or inpatient were more likely to be younger and to have more severe injuries. In cases where a consult was obtained, there was 100% adherence to emergency department clinical guidelines vs 66% when no consult was obtained. In addition, in cases that did not receive a child abuse consult, 8% had to return to the hospital for labs or radiographs after their emergency department visit.
  
  
  CONCLUSIONS
  Child abuse consultation in the pediatric emergency department improves compliance with clinical guidelines and decreases the likelihood that patients will need to return for further testing.
authors.forename: Tara
authors.initials: T
authors.lastname: Webb
authors.forename: Thomas
authors.initials: T
authors.lastname: Valvano
authors.forename: Melodee
authors.initials: M
authors.lastname: Nugent
authors.forename: Marlene
authors.initials: M
authors.lastname: Melzer-Lange
mesh_terms: D002648:Child; D002649:Child Abuse / Q000175:diagnosis*; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D010372:Pediatrics / Q000592:standards*; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D012189:Retrospective Studies; D014922:Wisconsin