Outpatient Specialty Care and Primary Care Pathway for Evaluation/Treatment of Children with Physical Abuse Concerns

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
    • 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
    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.
No CPS report indicated
Routine follow-up
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