Gothard T W, Runyan D K, Hadler J L
J Emerg Med. 1985;3(3):181-94. doi: 10.1016/0736-4679(85)90070-8.
Child maltreatment continues to be one of the most common and most difficult problems seen in the emergency room. An early estimate indicated that up to 10% of children under age 6 seen in emergency departments have some form of nonaccidental injury. Recent data suggest that approximately 1% of the child population are victims of maltreatment each year. Many of these cases involve only subtle signs and have great potential to pass undetected. This article provides a review of the various forms of maltreatment, with emphasis on the key points involved in the history, physical examination, and management. The protocol for evaluating maltreatment from the North Carolina Memorial Hospital is presented. This framework will aid the physician in the crucial first step of identifying maltreatment, which, along with diligent follow-up and the assistance of the available social services, offers the best hope for further prevention.
儿童虐待仍然是急诊室中最常见且最棘手的问题之一。早期估计表明，在急诊科就诊的6岁以下儿童中，高达10%遭受过某种形式的非意外伤害。近期数据显示，每年约1%的儿童是虐待行为的受害者。这些案例中许多仅存在细微迹象，极有可能未被察觉。本文综述了各种形式的虐待行为，重点关注病史、体格检查及处理过程中的要点。还介绍了北卡罗来纳纪念医院评估虐待行为的方案。这一框架将有助于医生在识别虐待行为的关键第一步中提供帮助，而这一步骤与勤勉的后续跟进及现有社会服务机构的协助相结合，为进一步预防提供了最大希望。
