739 Detection of Suspected Child Abuse at Emergency Departments, a Multi- Center Study

Abstract

Background: Recognizing child abuse in an early stage or preventing recurrent abuse is crucial but difficult. Implementing screening guidelines for child abuse at emergency departments (ED) could be effective to increase the detection rate. We assessed detection rates of child abuse at ED of seven hospitals with and without screening guidelines in the Netherlands.Methods: During six months data on demographics, diagnosis and suspected child abuse were collected for all children up to 18 years old visiting the ED. Beforehand ‘having clear screening guidelines’ was operationalized as a completion rate of a checklist for alarming factors for child abuse in at least 10% of the ED visits.Results: 24,472 children visited the ED of whom 54% visited an ED with screening guidelines for child abuse. In 52 children (0.2%) child abuse was suspected at the ED, in 40 (77%) of these cases a checklist for alarming factors was completed versus 19% of completed cases in the total sample. Children in whom a suspicion of abuse arose at the ED were younger and more often male than the general ED population. The majority concerned physical abuse. In hospitals with screening guidelines for child abuse the detection rate was higher (0.3%) compared to hospitals without a screening policy (0.1%, p < 0.001).Conclusions: In a timeframe of six months a suspicion of child abuse arose at the ED in 0.2% of all visiting children. Numbers of detected abuse were very low, but improvements are likely if uniform screening guidelines are present.