Your first concern when treating an abused child is to be sure all life-threatening injuries are treated first.

Check the child’s airway, breathing, and circulation. Treat, if necessary.

a. Identification Procedures. Begin with identification procedures.

(1) Patient history. Obtain this information from the parent or child, depending on the age and physical condition of the child.

(a) What is the patient’s general health? Good? Fair? Poor?

(b) Which childhood illnesses has the child had? Ask about measles, mumps, whooping cough, chickenpox, smallpox, scarlet fever, acute rheumatic fever, diphtheria, poliomyelitis.

(c) Has the child had any other major illnesses?

(d) Has the child been admitted to a hospital for any problem that did not require surgery?

(e) What immunizations has the child had? Ask about polio, diphtheria, pertussis, and tetanus toxoid, influenza, cholera, typhus, typhoid, last PPO or other skin tests. Ask if the patient had any unusual reactions to immunizations.

(f) Has the child had any surgery? If so, ask the dates, hospital, diagnosis, and complications of the surgery.

(g) Has the child had any broken bones or other physical trauma such as blunt instrument trauma? (You are asking about serious injuries.)

(h) Is the child taking any medications? Ask about current or recently taken medications. Ask about the dosage for either a home remedy or prescribed medication.

(i) Does the child have any allergies? Ask about allergies to medications, environmental allergens, and foods.

(j) Has the child ever had a transfusion? If so, ask about his reactions, the date, and the number of units transfused.

(2) Physical examination. Examine the child thoroughly from head to toe.

(a) Search for lacerations, abrasions, trauma, and evidence of internal injury while you are performing a regular physical examination.

(b) Perform your physical examination normally. Do NOT voice your suspicions of child abuse or confront the parents.

(c) Note all evidence or findings in writing.

CAUTION: Keep all suspicions to yourself. It is NOT the medic’s responsibility to confront the parents with the charge of child abuse.

b. Treatment. Treat the child for all injuries as appropriate.

c. Report. Prepare a report for the medical staff.

(1) Record your observations about the child’s injury. Omit writing or speaking about child abuse or a battered child in your report. Use the initials N.A.T. (nonaccidental trauma) or the initials S.C.A.N. (suspected child abuse and neglect).

(2) Record your observations at the scene of the injury (if you are not in a medical treatment facility). If you are in the victim’s home, describe the condition of the home specifically. List any objects that were used to hurt the child, objects such as belts or straps.

(3) Transport the child to a medical treatment facility.

CAUTION: DO NOT confront the parents with your suspicions of child abuse. Your responsibility is to treat the child and get the child to a medical treatment facility.