Child Abuse and the Pediatric Surgeon: An APSA Position Statement | Traumatic Disease (justifies use of our trauma system) | Multidisciplinary Care (for evaluation & management) | Admit to Surgery (risk & care coordination) | Children's Surgery Verification QUALITY IMPROVEMENT PROGRAM | Child Abuse Team (it's a requirement) | Systematic Evaluation (protocols & education) | Universal Screening (does not discriminate) | CPS Mandated Reporting (even when transferring) | Abusive Head Trauma (permanent sequelae exist) | NTDB NATIONAL TRAUMA DATA BANK | ACS TQIP TRAUMA QUALITY IMPROVEMENT PROGRAM pediatric | Data Collection (for quality improvement) | Journal of Pediatric Surgery | Escobar Jr M, Wallenstein K, Christison-Lagay E, Naiditch J, Petty J. (2019) https://doi.org/10.1016/j.jpedsurg.2019.03.009 | @alejandracasar
Child Abuse and the Pediatric Surgeon: An APSA Position Statement
Infographic · Jul 2019 · 1 min read
In brief
In brief
APSA position statement advocating for standardized screening tools and trauma system resources for child physical abuse cases. Recommends surgical service admission for suspected abuse victims due to polytrauma risk, while emphasizing multidisciplinary collaboration with child abuse pediatricians and CPS.
- Child physical abuse qualifies as traumatic disease warranting full trauma system resources and pediatric surgeon evaluation.
- Implement standardized screening tools for child abuse at all state-designated trauma centers and children's surgery hospitals.
- Admit suspected abuse patients to surgical trauma service due to polytrauma risk and need for coordinated multidisciplinary care.
- Pediatric surgeons must collaborate with child abuse pediatricians, social work, and CPS in suspected abuse cases.
- Reporting suspected abuse to Child Protective Services is legally mandated; document cases in trauma registries for quality improvement.
Written by the GCMD Library team from the infographic.
A teal-blue infographic organized in a 3x3 grid layout with white icons and text. Each section pairs a simple white pictogram (showing concepts like physical abuse, hospital admission, multidisciplinary teams, checklists, reporting symbols, screening icons, data collection, and a CT scan image) with explanatory text. The APSA logo appears in the top right corner, and journal citation information is at the bottom with an author photo.
The pediatric surgeon is in a unique position to assess, stabilize, and manage a victim of child physical abuse (formerly nonaccidental trauma [NAT]) in the setting of a formal trauma system.
Methods
The American Pediatric Surgical Association (APSA) endorses the concept of child physical abuse as a traumatic disease that justifies the resource utilization of a trauma system to appropriately evaluate and manage this patient population including evaluation by pediatric surgeons.
Results
APSA recommends the implementation of a standardized tool to screen for child physical abuse at all state designated trauma or ACS verified trauma and children’s surgery hospitals. APSA encourages the admission of a suspected child abuse patient to a surgical trauma service because of the potential for polytrauma and increased severity of injury and to provide reliable coordination of services. Nevertheless, APSA recognizes the need for pediatric surgeons to participate in a multidisciplinary team including child abuse pediatricians, social work, and Child Protective Services (CPS) to coordinate the screening, evaluation, and management of patients with suspected child physical abuse. Finally, APSA recognizes that if a pediatric surgeon suspects abuse, a report to CPS for further investigation is mandated by law.
Conclusion
APSA supports data accrual on abuse screening and diagnosis into a trauma registry, the NTDB and the Pediatric ACS TQIP® for benchmarking purposes and quality improvement.
Visual abstract created by Alejandra M Casar Berazaluce, MD - Pediatric Surgery Research Fellow at Cincinnati Children's Hospital Medical Center.