Episode 74: Child Abuse in the Pediatric Emergency Department, How Can We Make Things Better?

November 6, 2023 | 6:05 am

As a PEM Physician, child abuse, sexual abuse and child neglect cases are those cases I never want to miss or overlook. That is often easier said than done. This is a discussion I had with Dr. Stephen Boos, a child abuse doctor in Western MA.

Check out this episode!

Thank you all for listening to PEM Rules!  As requested, please see list of references below used for Dr. Boos’s Child Abuse guidelines as well as the guidelines used at the Childrens’ Hospital of Pittsburgh,


Hymel KP, Laskey AL, Crowell KR et al. Racial and ethnic disparities and bias in the evaluation and reporting of abusive head trauma. J Pediatr. 2018; DOI:10.1080/10538712.2018.1443303

Rinney LC, Frey TM, Fain ET, et al. Standardizing the evaluation of nonaccidental trauma in a large pediatric emergency department. Pediatr. 2018; DOI:10.1542/peds.2017‐1994

Wood JN, Fakeye O, Mondestin V, et al. Development of hospital‐based guidelines for skeletal survey in young children with bruises. Pdiatr. 2015; DOI:10.1542/peds.2014‐2169

Wood JN, Fakeye O, Feudtner C, et al. Development of guidelines for skeletal survey in young children with fractures. Pediatr. 2014; DOI:10.1542/peds.2013‐3242

Wootton‐Gorges SL, Soares BP, Alazraki AL, et al. ACR appropriateness criteria suspected physical abuse‐ child. J Am Coll Radiol. 2017; 14: S338‐S349

Pierce MC, et al. Validation of a Clinical Decision Rule to Predict Abuse in Young Children Based on Bruising Characteristics. JAMA Netw Open. 2021 Apr 1;4(4):e215832. doi: 10.1001/jamanetworkopen.2021.5832.

Escobar, M. A,. Flynn-O’Brien, K. T., et al… (2017). The association of nonaccidental trauma with historical factors, examination findings, and diagnostic testing during the initial trauma evaluation. Journal of Acute Care Surgery, 82(6), pp. 1147-1157

ACS Trauma Quality Programs Best Practices Guidelines for Trauma center Recognition of Child Abuse, Elder Abuse, and Intimate Partner Violence Abuse-Violence.pdf (pediatrictraumasociety.org)

Berger RP, Fromkin ,J Herman B, Pierce MC, Saladino RA, Flom L, Tyler-Kabara EC, McGinn T, Richichi R, Kochanek PM. Validation of the Pittsburgh Infant Brain Injury Score for Abusive Head Trauma. Pediatrics. 2016 Jul;138(1):e20153756. doi: 10.1542/peds.2015-3756. Epub 2016 Jun 23. PMID: 27338699; PMCID: PMC4925074.