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

MD/CRNP/RN Rapid Assessment

General

Review VS, place on CR monitor per policy
Notify MD if concerned about patient’s appearance
Have child change into gown
Assess need for analgesia, notify MD
For patients with likely fracture, reinforce NPO status

Details of Injury Time

Mechanism
Initial manifestations
Neurologic symptoms

Physical Exam

Brief neurologic exam
Focused exam of injury, notify MD regarding need for X-ray