Emergency clinicians are likely to encounter physical abuse in children, and they must be prepared to recognize its many manifestations and take swift action. Pediatric nonaccidental injury causes considerable morbidity and mortality that can often be prevented by early recognition. Nonaccidental injuries present with a wide array of symptoms that may appear to be medically inconsequential (such as bruising in a premobile infant), but are actually sentinel injuries indicative of child abuse. This issue provides guidance regarding factors that contribute to abuse in children, key findings on history and physical examination that should trigger an evaluation for physical abuse, and laboratory and radiologic tests to perform when child abuse is suspected.
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Using supervised machine learning and ICD10 to identify non-accidental trauma in pediatric trauma patients in the Maryland Health Services Cost Review Commission dataset.
Child Abuse Negl
February 2025
Johns Hopkins School of Medicine, United States of America. Electronic address:
Background: Identifying non-accidental trauma (NAT) in pediatric trauma patients is challenging. We developed a machine learning model that uses demographic characteristics and ICD10 codes to detect the first diagnosis of NAT.
Methods: We analyzed data from the Maryland Health Services Cost Review Commission (2015-2020) for patients aged 0-19 years.
Improving the evaluation of non-accidental trauma across multiple specialties at a single institution.
BMJ Open Qual
January 2025
Inova Fairfax Medical Campus, Falls Church, Virginia, USA.
Background: Based on the presenting injury, patients undergoing abuse evaluation may be managed by different specialties. Our local child abuse specialist expressed concern over the variability in evaluation of patients presenting with injuries concerning for non-accidental trauma (NAT). The aim of this quality improvement project was to increase the percentage of patients for whom there is a concern for NAT who receive a guideline-adherent evaluation from 7.
View Article and Find Full Text PDFThe mechanism-specific injury mortality burden associated with heatwave in China in a warming world.
Environ Int
January 2025
Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; Key Laboratory of Viral Pathogenesis & Infection Prevention and Control (Jinan University), Ministry of Education, Guangzhou 510632, China. Electronic address:
Numerous studies have investigated the impact of heatwaves on non-accidental mortality, yet the association and burden of heatwaves on mechanism-specific injury mortality remain underexplored. This study collected 257,267 injury-related fatalities and corresponding daily maximum temperatures (DMT) across seven Chinese provinces from 2013 to 2023. A heatwave was characterized by two or more successive days where the DMT surpassed its 92.
View Article and Find Full Text PDFThe pediatric Brain Injury Guidelines: a retrospective clinical validation study.
J Neurosurg Pediatr
January 2025
4Department of Neurosurgery, Children's Hospital Colorado Anschutz Medical Campus, Aurora; and.
Article Synopsis
- The study aimed to evaluate the pediatric Brain Injury Guidelines (pBIG) for identifying pediatric patients with traumatic intracranial hemorrhage (ICH) who may not need further neuroimaging or hospitalization.
- A total of 955 patients were analyzed, with findings showing that the majority had pBIG 2 or 3 injuries, and nearly 40% of those who had repeat imaging showed hemorrhage progression.
- Those meeting pBIG 3 criteria were significantly more likely to need surgical intervention or face higher mortality rates, emphasizing the importance of the guidelines in determining treatment urgency.
Esophageal Perforation Resulting From Nonaccidental Trauma in a Neonate: A Case Report.
Cureus
November 2024
Pediatrics, Hurley Medical Center, Flint, USA.
Esophageal perforation (EP) resulting from nonaccidental trauma in a neonate is extremely rare. We report a previously healthy 12-day-old neonate presenting with stridor, respiratory distress, and bloody vomitus. Clinical, radiographic, and endoscopic evaluations confirmed the diagnosis of EP.
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