A child presenting to a primary care provider with an injury can be screened for child abuse using a simple flow chart. The authors are from Frenchay Hospital in Bristol, England.
Question
Response
Points
Has there been a delay between injury and seeking medical advice for which there is no satisfactory explanation?
no
0
yes
1
Is the history consistent each time it is taken?
yes
0
no
1
On examination does the child have any unexplained injuries?
no
0
yes
1
Is the child's behavior and interaction appropriate?
yes
0
no
1
where:
• In the implementation I added an additional question: "On examination does the child have any injuries that are inconsistent with the history given?"
score =
= SUM(points for all of the questions)
Interpretation:
• minimum score: 0
• maximum score: 4 (or 5)
• A score >= 1 is suspicious for abuse. The case should be reviewed by a senior pediatrician or attending.
• A score = 0 indicates a low risk for abuse.
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