孩子的困惑.ppt

Suspect... Does the history fit what you are seeing- either injury or illness? Is this a repeat patient or family member of a repeat patient? Is there a history of family violence? Collect... Collect as much evidence as possible, including… physical and trace evidence information Respect... Respect the right to refuse Respect diversity Respect privacy The Cycle of Abuse... Family violence Abuser-to abuser cycle Factors in altering the cycle of violence Responsibilities to Report... Who must report… Deciding to report… A report of suspected child abuse is a responsible attempt to protect a child. Identifying Physical Abuse... By the Family Doctor Normal childhood development Conditions that may be confused with abuse Unintentional vs intentional injury Recognizing Abuse Injuries... Skin Injuries TEARS Human Bite Marks Hair Loss Falls Head, facial, oral injuries Shaken baby Syndrome Human Bites Strongly suggest abuse Easily overlooked Location of bite marks on infants differ from sites on older children Bruises Generally speaking: fresh injury is red to blue 1-3 days deep black or purple 3-6 days color changes to green and then brown 6-15 days: green to tan to yellow to faded, then disappears The younger the child the quicker the color resolves. Bruises Burns Abusive Burn Patterns Scald: Immersion Splash Burns Flexion Burns Contact Burns “Pseudoabusive” Burns Burns Suspicious Fractures Falls In most cases, falls cause a minor injury. If a child is reported to have had a routine fall but has what appear to be severe injuries, the inconsistency of the history with the injury indicates child abuse. Head, Facial, Oral Injuries Head is a common area of injury. Approx. 50 % of physical abuse patients have head or facial injuries. Injuries to the sides of the face, ears, cheeks, and temple area are highly suspicious for abuse. Mouth/lip/teeth injuries Indicators of Child Abuse (Discovered by Family Doctor) Type of Abuse Physical Indicators Behavioral Indicato