Primary Care Pathway for Evaluation/Treatment of Children with Physical Abuse Concerns
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Low concern for abuse
  • History, PE not Supportive/Suggestive of Abuse
  • +/- Historical indicators
  • Physical exam indicators of abuse explained by history
  • No injuries indicative of abuse present
Concern for abuse
  • History, PE or Injuries Concerning for Abuse
  • Photodocumentation
  • Identify Other Children at Risk
  • Report to CPS – View Policy
    • Use on-line portal
    • Call CPS if either of the following:
      • Immediate safety concerns for discharge
      • Concern for other children in the home at risk
    • Complete online portal within 48 hours of call
    Note:
    Clinicians with a concern for possible abuse are obligated to report to CPS even if the child is referred for further medical evaluation. Inform family of CPS report.
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No CPS report indicated
Routine follow-up
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Discharge Home
  • No concern for injuries requiring medical evaluation
  • No indications for occult injury evaluation
  • No immediate safety concerns
Referral to ED
Posted: September 2018
Revised: November 2018
Authors: P. Scribano, MD; J. Wood, MD; K. Henry, MD; V. Scheid, MD; L. Palacio, LSW; C. Jacobstein, MD; J. Lavelle, MD