11 Child Abuse

2 types

• abuse

  • positive symptoms. Doing something bad

  • intentional, active harm

• neglect

  • negative symptoms. Not doing something good

  • passive, absence

Risks

Children: Require more attention

• intellectually disabled

• Prematures

• Disabled: physical or cognitive

Adult: Harder for parenting

• single parent

• Young

• low socioeconomic status

• nonbiological status

• have been abused

Presentation

Injuries

• Fractures: skull, femur

• Bruises: different stages of healing, location (back), subdural hematoma

• Burns

  • Dunk wounds: hold by wrist and dunk in to tub (butt burns or foot burns)

  • Punctate circular: cigarettes

• Sexual

  • any STD in child

  • Anal/vaginal trauma: look under anesthesia

Pt

• Absence of crying with injury in presence of caretaker: child learn if cry = abuse

• runs from caretaker

• finds comfort in healthcare provider

Provider Responsibility

1. identify it's happening

2. record

3. keep child safe

Report to

• child protective services

• family: explain to family why you are doing this

Safety

• separate child from abuser

• separate parent-child unit from common abuser

• hospitalization: last resort

Cope: abuse happen because parent does not know how to cope and from lack of understanding. Goal not pull famly apart.