Being a Kid Should Be Fun: Recognition of Non-Accidental Trauma-Handout: Being a Kid Should Be Fun: Recognition of Non-Accidental Trauma

Handout: Being a Kid Should Be Fun: Recognition of Non-Accidental Trauma

Pdf Summary

This presentation on recognizing non-accidental trauma (NAT) in children focuses on the definition, warning signs, evaluation, and reporting responsibilities for suspected child abuse. It explains that child abuse can include physical, emotional, sexual abuse, and neglect, and that these forms often overlap. Abuse is common, costly, and most severe in infants, with child fatalities and injuries disproportionately affecting very young children.<br /><br />The talk reviews key clinical clues by age group. For verbal children, concerning findings include behavioral changes, fear, aggression, depression, self-harm, and inconsistent histories. For pre-verbal and preschool children, clinicians should look for bruising in high-risk locations and use the TEN-4-FACES-P screening tool. Specific injuries highlighted include frenulum injury, patterned bruising, submersion injuries, classic metaphyseal lesions, posterior rib fractures, and fractures in non-ambulatory infants. Abusive head trauma is emphasized as a major cause of death and disability, with symptoms such as vomiting, lethargy, seizures, apnea, coma, and findings like retinal hemorrhages, subdural hematomas, and diffuse axonal injury.<br /><br />The presentation outlines a practical NAT work-up: careful history-taking, documentation of inconsistencies, physical exam red flags, laboratory testing, skeletal survey, head CT, MRI, and abdominal imaging when indicated. It also stresses consultation with trauma, child protection teams, social work, ophthalmology, and other specialists, along with mandatory reporting to child protective services and/or law enforcement.<br /><br />A case study of an 11-month-old boy with a reported short fall demonstrates how severe head injury, acute-on-chronic subdural hematoma, and retinal hemorrhages can suggest NAT despite the initial story. The talk concludes that healthcare providers have a legal and moral duty to suspect, document, report, and protect vulnerable children.

Keywords

non-accidental trauma

child abuse

abusive head trauma

TEN-4-FACES-P

retinal hemorrhages

subdural hematoma

skeletal survey

mandatory reporting

frenulum injury

patterned bruising