Screening for NAI
All children with a suspicion of abuse or non-accidental injuries most be discussed with the duty senior ED Doctor, who will then decide if a referral to the on-call paediatric Consultant is appropriate.
The following circumstances should alert you to the possibility of a non-accidental injury or child abuse.
- Delay in seeking help
- Inconsistent history
- Unusual injury patterns
- Inappropriate behaviour / interaction of parent and child
Examples of suspicious injuries:
- Cigarette burns to face, head and trunk
- Demarcated iron burns
- Scald to the bottom, genitalia and both feet
- Torn frenulum of the tongue or tongue laceration in edentulous baby.
- Any fracture in an immobile child (< 1 Year old)
- Unusual injuries to the genitalia
- Multiple injuries, such as bruises or fractures, of different ages
Remember this list is neither exhaustive nor diagnostic of child abuse. You should therefore be professional and courteous to the parents at all times during your consultation with them.
Neglect
If you are concerned that a child is being neglected, refer to duty social worker.