child protection issue

I see there are no responses to date. That might be because this topic strikes fear in the hearts of most peds nurses... No one wants to be the one to identify a child in need of protection. A few years ago I attended a workshop on child protection issues and I know I have some notes around here somewhere. Rather than hunting for them for hours, I'll see what I can recall...

Physical abuse is often obvious: bruises in spots that are rarely bruised accidentally (cheeks, back, abdomen, pelvis) or bruises that are shaped like household items (hairbrush, wooden spoon, egg turner, whisk, extension cord etc); burns with demarcated areas or patterns; spiral fractures. Neglect is a little harder to detect but still has red flags: dirty, ingrown toenails and poorly fitting shoes; untreated impetigo with or without scarring; dental caries in several teeth; under- or over-weight; matted hair.

Emotional and sexual abuse are sometimes harder to detect still, emotional because we can't "see" into the child's spirit, and sexual because the areas of injury will be hidden. Emotional abuse will sometimes manifest in self-abuse: headbanging, biting hands or arms, abnormal attachment to both family members and strangers (opening them up to more exploitation), cutting. Sexual abuse has some physical signs, such as frequent bladder infections, yeast infections in prepubescent girls, rituals, vomiting without symptoms of GI distress. Some behavioural clues include avoidance of persons, places or situations that should not provoke that degree of anxiety, overtly sexual or provocative behaviours, sexual play with dolls, inappropriate language.

That might be enough for your purposes...

You're totally welcome. I wanted to give others a chance to jump in, but nobody took the opening. Glad we were on the same wave length.

Excellent response! Thank you...