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Child Abuse

Karen A. Hulbert, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Types of abuse: neglect (most common and highest mortality), physical abuse, emotional/psychological abuse, sexual abuse

  • Neglect includes physical (e.g., failure to provide necessary ...

DIAGNOSIS

  • Relatively minor injuries, frenulum tears, or bruising in precruising infants may be the first indications of child physical abuse; these minor, suspicious injuries have been termed “sentine...

TREATMENT

GENERAL MEASURES

  • If diagnosed with STI, treat promptly.

  • If HIV exposure possible, consider prophylaxis.

MEDICATION

First Line

Antibiotics as indicated for STIs 
Alert

Emergency contraception reduce...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

As clinically indicated 

Patient Monitoring

  • Monitor injury healing over time.

  • Follow up assessment for STIs that may not present acutely (e.g., HPV).

PROGNOSIS

Without...

REFERENCES

1
1 Children’s Bureau. Child maltreatment 2015. http://www.acf.hhs.gov/programs/cb/resource/child-maltreatment-2015. Accessed November 14, 2017.
2
2 Sheets LK, Leach ME, Koszewski IJ, et al. S...

ADDITIONAL READING

CODES

ICD10

  • T74.12XA Child physical abuse, confirmed, initial encounter

  • T74.32XA Child psychological abuse, confirmed, initial encounter

  • T74.22XA Child sexual abuse, confirmed, initial encounter

  • T74.92XA ...

CLINICAL PEARLS

  • When a bruise is present, it should be considered as potentially sentinel for physical abuse if no plausible explanation is given.

  • High index of suspicion is important for prevention an...

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