EM · Mandatory reporting and child protection

Mandatory reporting and child protection in the emergency department

Also known as Child abuse recognition · Non-accidental injury · Child maltreatment · Mandatory reporting · Safeguarding referral · Forensic chain of custody · Child sexual abuse examination · Fabricated or induced illness

Mandatory reporting and child protection in the emergency department — recognition of child abuse through the sentinel injuries (bruising in a non-mobile infant, the inconsistent or changing history, delay in presentation, fractures of different ages, the classic metaphyseal lesion and posterior rib fractures, and abusive head trauma with the subdural–retinal–encephalopathy triad), the validated TEN-4-FACESp bruising clinical decision rule (Pierce 2021, sensitivity 95.6 percent), child sexual abuse recognition with the STI screen, the time-windowed forensic examination and post-exposure prophylaxis (ceftriaxone, azithromycin, metronidazole, levonorgestrel, HIV PEP), the differential distinguished from accidental injury, cultural practices and fabricated or induced illness, the mandatory reporting legal duty and its reasonable-belief threshold, the forensic chain of custody, and the safeguarding referral. ACEM-primary, globally tagged.