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Non-accidental injury — DIPIMC MCQ

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HardPaediatric and Obstetric EmergenciesNon-accidental injuryDIPIMCDipIMC

An infant has patterned bruising, delayed presentation and injuries that do not fit the history. The child is clinically stable after immediate treatment. What should the clinician do next?

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Correct answer: C — Document objectively and activate the child-safeguarding pathway

The best answer is “Document objectively and activate the child-safeguarding pathway”. Patterned bruising and an unsuitable explanation in an infant are features that should prompt concern for maltreatment. Provide necessary care, record the history and findings factually, consider immediate safety and share the concern through the local safeguarding pathway. The clinician need not prove abuse. Confrontation can increase risk and compromise investigation, while delay leaves a potentially vulnerable child unprotected.

Reference: NICE CG89, Child maltreatment: https://www.nice.org.uk/guidance/cg89/chapter/recommendations