Assess for These Red Flags for Abuse
Below is a list of some things that EPs should consider to be red flags for abuse, according to Daniel M. Lindberg, MD, an attending physician in the Department of Emergency Medicine at Brigham and Women’s Hospital and assistant professor of medicine at Harvard Medical School, both in Boston:
• Serious brain injury after a reported short fall;
• Serious injury reported to be inflicted by a young (pre-verbal) sibling;
• Unexplained delay in seeking care;
• History changes over time or between caregivers;
• No history offered to explain serious injury;
• Bruising in children who can’t “cruise;”
• Oral (labial, sublingual) frenulum tears in children who can’t cruise;
• Bruising to the abdomen, ears, genitals, neck;
• Patterned bruises or burns;
• Retinal hemorrhages;
• Subdural hematoma in a child < 24 months old;*
• Rib fractures in children < 24 months old;*
• Long-bone fracture in infants < 12 months old;*
• Abdominal organ injury in children < 24 months old;* and
• Multiple fractures in different stages of healing.*
* Concern for abuse isn’t usually raised when these injuries are found after a motor vehicle crash, or after a serious trauma witnessed by several disinterested people.
Sources
For more information, contact:
- Michael Gerardi, MD, FAAP, FACEP, Director, Pediatric Emergency Medicine, Goryeb Children’s Hospital, Morristown, NJ. Phone: (973) 740-0607. E-mail: [email protected].
- Daniel M. Lindberg, MD, Department of Emergency Medicine, Brigham & Women’s Hospital, Boston, MA. Phone: (617) 525-8025. E-mail: [email protected].
- Samantha L. Prokop, JD, Brennan, Manna & Diamond, LLC, Akron, OH. Phone: (330) 253-3766. E-mail: [email protected].
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