***Trigger warning: this episode includes discussion of child abuse***
As emergency physicians, we are uniquely positioned to identify and address child abuse, or non-accidental trauma (NAT). It’s a challenging part of our job, but our vigilance can save a child’s life. Signs of abuse can often be subtle, but there are some very specific findings that should make us consider NAT. In this episode, we talk with expert, Dr. Mary Clyde Pierce, about her recently published paper, coauthored by our own Dr. Julia Magaña, validating the TEN-4 FACESp clinical decision rule to predict abuse in young children.
Have you used TEN-4 FACESp to identify potential non-accidental trauma? Share your experience with us via social media, @empulsepodcast, or through our website, ucdavisem.com.
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Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis
Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis
Dr. Mary Clyde Pierce, Professor of Pediatrics at Northwestern University, Pediatric Emergency Physician and Director of Child Abuse Research at Laurie Children’s Hospital.
Pierce MC, Kaczor K, Lorenz DJ, Bertocci G, Fingarson AK, Makoroff K, Berger RP, Bennett B, Magana J, Staley S, Ramaiah V, Fortin K, Currie M, Herman BE, Herr S, Hymel KP, Jenny C, Sheehan K, Zuckerbraun N, Hickey S, Meyers G, Leventhal JM. 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.
Lorenz DJ, Pierce MC, Kaczor K, Berger RP, Bertocci G, Herman BE, Herr S, Hymel KP, Jenny C, Leventhal JM, Sheehan K, Zuckerbraun N. Classifying Injuries in Young Children as Abusive or Accidental: Reliability and Accuracy of an Expert Panel Approach. J Pediatr. 2018 Jul;198:144-150.e4. doi: 10.1016/j.jpeds.2018.01.033. Epub 2018 Mar 15. PMID: 29550228; PMCID: PMC6019119.
CDC Morbidity and Mortality Weekly Report: Trends in US Emergency Department Visits Related to Suspected or Confirmed Abuse and Neglect Among Children and Adolescents Aged <18 Years Before and During the COVID-19 Pandemic – United States, January 2019-September 2020