ED Pathway for Evaluation/Treatment of Children with Physical Abuse Concerns

Screen for Occult Injuries

  Head CT or MRI Skeletal Survey Labs** Abdominal CT
0-12 months
  • Obtain CT if symptomatic
  • Consider CT if evidence of CHI on PE
    Schedule MRI for asymptomatic infants & admit for MRI
Yes Yes
Obtain if
symptomatic or
suggested by
physical exam
12-24 months No Yes Yes
2-6 years No No* Yes
7-18 years No No No

*In rare cases, skeletal survey may be recommended by the SCAN team in Children aged 2-3 yo

**CBC, PT/PTT, BMP, hepatic function panel, amylase, lipase, urinalysis in all patients
If patient requires blood products, draw vWF antigen and activity, Factor VIII and IX level

Any child who resides in a home with a child who has suspected abusive injuries should have a full, age-appropriate screening for occult injuries.