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Health Care Providers May Be Missing Signs of Child Abuse

Some hospitals screen every infant with a femur fracture; others screen none

MONDAY, July 13, 2015 (HealthDay News) — Many U.S. hospitals are missing opportunities to detect physical abuse in infants and toddlers, according to research published online July 13 in Pediatrics.

The findings are based on records from 4,486 children younger than 2 who were treated at 366 U.S. hospitals. All already had been diagnosed with physical abuse or they had an injury highly suggestive of abuse: namely, a femur fracture or a traumatic head injury such as intracranial hemorrhage.

Of the children already diagnosed with abuse, only 48 percent underwent X-rays to check for occult fractures. Similarly, just over half of the children with suspicious injuries were screened. Hospitals ranged widely in their practices. Some, for example, screened every infant with a femur fracture — an injury frequently caused by abuse; others screened none of those patients.

“Based on past research, we knew there would be variation among hospitals,” lead researcher Joanne Wood, M.D., who is based at the University of Pennsylvania and Children’s Hospital of Philadelphia, told HealthDay. “But we were surprised at the magnitude of the variation.” The reasons are not clear, Wood said. At some hospitals, she speculated, staff may be unaware of the guidelines. At others, there may be no one available to do an X-ray, especially for children brought in at night. In some cases, Wood added, a child’s injury may simply not have raised that particular doctor’s suspicions.

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