182790 Nonfatal child injury - multiagency review for possible child abuse

Tuesday, October 28, 2008: 11:30 AM

Michael Durfee, MD , ICAN National Center on Child Fatality Review, La Canada, CA
Multiagency review teams are being developed for nonfatal/severe child injury. About 1,000 child death review teams exist in multiple countries, but, the child needs to die. Nonfatal severe abuse adds the potential for intervention after injury but before death. Systematic intake will add cases that are missed today. The ICAN National Center for Child Fatality Review is working with other states that have some nonfatal review. An LA County pilot program is developing with plans for other counties. A working model with initial data will be available for APHA, presentation. Teams will be connected to hospitals with multiple agencies participating in case selection. Intake would consider all ages but focus under age two on hospitalized head trauma. That could begin with about 3800 California children < 2y/o a year hospitalized for injury, including about 250 coded as assault injury in hospital discharge data. Los Angeles County will add a model multiagency data base to find other agencies who have served the same family. Teams will include health, CPS, public health, law enforcement, fire EMT, prosecutors, schools and mental health. Additional services will include grief and trauma support for surviving siblings. Acute hospitals will be augmented by child burn centers and neuro-rehab units. Other considerations include incestuous pregnancy, abandoned newborn, unexplained HIV and unexplained developmental disability. Hospital discharge data will provide a measure of hospital activity with child injury that can be matched to child abuse reports. Health professionals and health data will provide tools for prevention

Learning Objectives:
1 Describe the differences between multiagency nonfatal and fatal child injury review 2 Describe similarities between multiagency fatal and nonfatal child injury review. 3 Note three types of injury that might be from child abuse. 4 Describe a potential role for hospital discharge data in detection of child abuse 5 Describe the value of child grief support for families with fatal and severe child injury.

Keywords: Child Abuse, Injury

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: 33 years full time with child abuse programs, board certified child psychiatrist, 43 years with children hospitalized for trauma, published, grant funded...
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.