Non-Accidental trauma is a medical and social emergency
In the United States over 675,000 children suffer from abuse or neglect annually.
Pediatric physical abuse makes up approximately 10% of child maltreatment, with up to 2,500
annual deaths due to inflicted injuries. The World Health Organization estimates abuse and/or
neglect account for 13% of the 1.2 million annual deaths due to injury in children less then 15
These are staggering numbers and physicians are often the first line for recognition.
Being able to recognize the signs and symptoms of suspected abuse is critical as children
who are returned to their families without further investigation or intervention are up to 50%
more likely to suffer subsequent abuse. A study of 5,400 hospitalized children with physical
abuse revealed almost 5% had a previous hospitalization for injury.
Non-Accidental trauma is a medical and social emergency. Despite the mandate to
report such cases it remains under identified and underreported. Emergency medicine
providers are in a unique position to recognize and prevent further injury as it is estimated 2% -to 10% of children visiting the ED are victims of abuse or neglect.
The identification of suspected abuse in pediatric patients is often a difficult diagnosis and even more difficult to navigate. It relies heavily on the provider’s index of suspicion as well as knowledge and expertise.
1. Colbourne, M., & Clarke, M. (2020). Child Abuse and Neglect. In Tintinalli’s Emergenct
Medicine: A comprehensive Study Guide Ninth Edition (pp. 988-995). McGaw-Hill Education
2. Boos, S. (2022, Feb 24). Physical Chils Abuse: Recognition. Retrieved from Uptodate:
3. Boos, S. (2021, Nov 11). Physical Child Abuse: Diagnostic Evaluation and Management.
Retrieved from Uptodate: https://www.uptodate.com/contents/physical-child-abusediagnostic-