Assessmentof injuries
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The document discusses assessing injuries from child abuse. It notes that 70% of injuries will be on the back, shoulders, and back of legs. Bruises may indicate the instrument used, such as a hand, belt, or wire. Cluster bruises and bruises on both sides of the body indicate repeated contact. The angle of attack provides information on the victim's position relative to the perpetrator. Other injuries include bite marks, pinch marks, pulled hair, and defensive marks on forearms. Internal injuries from blows can cause serious damage to organs and occasionally death, even with significant delays in medical care. Surface evidence of internal trauma is rarely visible, but symptoms may include distended abdomen, blood in urine, vomiting, abdominal pain
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Assessmentof injuries
- 2. Assessment of Injuries • Primary target zone: 70% of injuries will be located on the posterior, shoulders to back of legs. This area is well protected and hidden from view • Configuration: Bruises in specific pattern that might resemble the instrument used, ex. Hand, belt buckle, wire, coat hanger, etc. • Cluster bruises: indicated repeated contact with a hand or instrument. • Bruises which are found on more than one side of body.
- 3. Assessment of Injuries • Angle of attack, will tell you how victim was positioned in regard to the perpetrator. • Bite marks, pinch marks, hair pulled out. If more than 3cm, an adult bite. • Defense marks. Forearms held out to protect buttocks, etc. Grab marks look underneath the arms. Students remember as we progress through injuries and become angry with abusers, that children love their parents and we need to keep this in perspective
- 4. Burns 1. Immersion burns indicating dunking in a hot liquid. “Stocking” burns on the arm or legs, “Doughnut” shaped burns on the buttocks; any burn which stops at distinct boundry line. 2. Cigarette burns have a crater appreance. 3. Dry burns(no blisters)
- 5. Lacerations & Abrasions 1. Loop type as in electrical cords 2. Wraparound caused by belts 3. Buckle impressions 4. Attempt to locate instrument causing injury(be creative)
- 6. Internal Injuries/Pummeling 1. Blows to the body may cause serious internal injuries to the liver, spleen, pancreas, kidneys, and other vital organs. Occasionally these injuries may cause shock and result in death. Lethal abdominal trauma in children requires forces comparable to a motor vehicle running over them. Most children who die of this have had significant delays in medical care. This is the second leading cause of death for victims of child abuse.
- 7. Internal Injuries/Pummeling Detectable surface evidence of such trauma is rarley present. Evidence of such trauma includes: • Distended abdomen • Blood in urine • Vomiting • Abdominal pain • Shock