This document discusses child abuse from an EMS perspective. It begins by outlining the four major categories of child abuse: neglect, physical abuse, sexual abuse, and emotional abuse. It then provides statistics on child abuse in the US and Idaho. The document discusses signs of abuse, characteristics of victims and perpetrators, specific types of injuries to watch for, cultural practices that can mimic abuse, and requirements for reporting suspected abuse.

1. Child Abuse: An EMS Nightmare By Robert S. Cole Paramedic, CCEMT-P

2. "There is no more fundamental test of a society than how it treats its children." By: --Ronald Reagan

26. Multiple bruises at different stages of healing, dating of bruises by appearance (estimates): Health condition, medication therapy, and other variables come into play. clearing 2-4 weeks brown 10-14 days Yellow to green 4-10 days Blue Swollen , Tender 6-12 hours Red, swollen, tender < 6 hrs Appearance Age of bruise

32. Bite Marks

38. Courtesy of David Effron, M.D.

50. Coining

51. Coining

52. Cupping

55. Stick Burns and Moxibustion

59. Mongolian Spots

60. Mongolian Spots

70. Taking the report Do not discuss what the child told you with anyone who is not directly involved in helping the child. Do be supportive. Remember why the child came to you. S/he needs your help, support, and guidance. Let the child know that telling was the right thing to do. Do not investigate or push the child into giving details of the abuse. Your job is to listen to what the child wants to tell you. Do tell the child the abuse was not her/his fault and that s/he is not bad or to blame. Do not ask direct questions of the child - this might compromise the investigation. Do listen carefully to what the child is saying. Do not make promises you cannot keep, especially that you will not tell anyone. Do use the child's own vocabulary. DONT’S DO’s

71. Taking the report (cont) Don’t document opinions or speculations Do Document thoroughly, objectively Document your reporting of the suspected abuse. Do not delay in making the report. You could be the last hope for this child. Do immediately make a report to CPS without further questioning the child or contacting the family. Do not have an out-of-control reaction. Anger and disbelief can cause the child to take back their disclosure. Do tell the truth and be specific; let the child know you will be making a report to get him/her help. Do not notify the parents or anyone (outside of health care and law enforcement) involved in the case when a report is made. The CPS worker will notify them. Do know your limits and what your role is; this is not a situation you can or should handle by yourself. DONT’S DO’s

77. Please visit the National Clearinghouse on Child Abuse and Neglect Information web site to learn more about mandated reporters state by state. http:// www.calib.com/nccanch/statutes/index.cfm#reporting

80. Questions???

82. www.adaparamedics.org 208-287-2972