NON-ACCIDENTAL INJURY IN CHILDREN (FROM NEW POLICE SURGEON - A PRACTICAL GUIDE TO CLINICAL FORENSIC MEDICINE, 1978, BY H S BURGES AND J E HILTON - SEE NCJ-61742)

• NCJ Number: 61754
• Author(s): H DE LA DAVIES
• Date Published: 1978
• Length: 21 pages
• Corporate Author: Hutchinson Benham Ltd
• Publication Format: Document
• Language: English
• Country: United Kingdom

Annotation

CONSIDERATIONS OF THE POLICE SURGEON IN EXAMINING INJURED CHILDREN ARE DISCUSSED; TOPICS INCLUDE THE PHYSICAL EXAMINATION, ACTION IN SUSPICIOUS CASES, AND SOCIAL, FAMILY, AND MEDICAL HISTORIES.

Abstract

EVERY INJURY TO A CHILD UNDER THE AGE OF 3 SHOULD BE CONSIDERED NONACCIDENTAL UNTIL PROVEN OTHERWISE. IN THE INTERPRETATION OF A CHILD'S INJURIES, THE POLICE SURGEON SHOULD BE SUSPICIOUS AT ALL TIMES AND NEVER BELIEVE ANYTHING RELATIVES OR THE VICTIM SAYS UNTIL HE CAN DETERMINE THAT THE INJURIES FIT THE GIVEN EXPLANATIONS. IN ADDITION, THE POLICE SURGEON SHOULD WORK TO DETECT THOSE CASES IN WHICH THE CHILD IS THE VICTIM OF REPEATED ASSAULT. DIAGNOSIS IS ACHIEVED BY CONSIDERING THE HISTORY OF THE INCIDENT, PAST HISTORIES OF THE CHILD AND PARENTS, EXAMINATION, AND SPECIAL INVESTIGATION. FACTORS TO BE CONSIDERED IN HISTORY-TAKING INCLUDE SOCIAL CLASS, AGE OF PARENTS, CHILD'S PATERNITY, FINANCIAL SITUATION OF THE FAMILY, HOUSING SITUATION, AND PRESENCE AND QUALIFICATIONS OF THE BABY SITTER, IF APPLICABLE. FAMILY HISTORY CONSIDERATIONS INCLUDE PARENTAL OCCUPATION AND BACKGROUND, POSSIBLE MISTREATMENT IN CHILDHOOD, AND POSSIBLE MENTAL ILLNESS. MEDICAL HISTORY OF THE PARENTS SHOULD ALSO BE DETERMINED. INQUIRIES OF THE CHILD'S PAST HISTORY SHOULD INCLUDE DETAILS OF AGE, BIRTH, WEIGHT, PREVIOUS ILLNESS, AND PREVIOUS INJURY. DURING THE EXAMINATION, THE CHILD SHOULD BE COMPLETELY UNDRESSED SO THAT THE WHOLE BODY MAY BE OBSERVED. HOWEVER SLIGHT, ALL INJURIES MUST BE RECORDED. SPECIAL INVESTIGATIONS SHOULD BE CONDUCTED WHEN CHILD ABUSE IS EVEN SUSPECTED; THE CHILD SHOULD BE HOSPITALIZED AND A FULL SKELETAL SURVEY, WHICH WILL INDICATE THE PRESENCE OF ANY HEALED FRACTURES, SHOULD BE CONDUCTED. IN SUSPICIOUS CASES, THE POLICE SURGEON MAY ACT AS A LIAISON OFFICER BETWEEN THE POLICE AND THE MEDICAL PROFESSION. SAFETY ORDERS OR CARE ORDERS MAY BE ISSUED TO REMOVE THE CHILD FROM THE HOME IF ABUSE IS SHOWN. IN CARE PROCEEDINGS, THE RISK OF THE CHILD RECEIVING FURTHER INJURY IF RETURNED TO THE HOME SHOULD BE STRESSED. ABUSE IS NOT LIMITED TO CHILDREN EXCLUSIVELY; RECENT INTEREST IN BOTH THE MEDICAL AND LAY PRESS HAS CENTERED ON THE SUBJECT OF BATTERED WIVES. FLOW CHARTS ARE INCLUDED IN THE CHAPTER AS WELL AS SUGGESTED READINGS. (LWM)