Nurses Role In Child Abuse

Nurses are the primary source of defense to protect the children from abusive relationship. Therefore, it is necessary that the nurses know how to identify the physical and behavioral signs of child abuse while assessing a child. Although it is mandated by the law, that nurses should report to Child Protective Services any suspicious findings about child abuse within an appropriate time limit. Nurses who works in the Emergency Department sees infants, and children admitted to the hospitals for treatment of injuries, ingestions, acute or chronic conditions, etc. They are in the front line for assessing the children who are the victims of child abuse. In the schools, the school nurses are holding a major position to first assess the school going
Nurses should be very careful while taking past medical history. A lack of consistent report of injury from the parents or caregiver could lead to a case of child abuse. On the other hand, a child abuse could be overlooked from a lack of thorough physical assessment. An abusive head trauma is also known as shaken baby syndrome. It is a serious brain injury resulting from forcefully shaking an infant or toddler. Shaken baby syndrome destroys a child's brain cells and prevents his or her brain from getting enough oxygen. It is a form of child abuse that can result in permanent brain damage or death. The signs and symptoms of shaken baby syndrome include: extreme irritability; difficulty staying awake; breathing problems; poor eating; tremors; vomiting; pale or bluish skin; seizures; paralysis and coma. Retinal hemorrhage are the hallmark of shaken baby syndrome. Other related injuries could be found out with further examinations include, bleeding in the brain and eye, damage to the spinal cord and neck and fractures of the ribs, skull and bones. It could be the evidence of prior child abuse, too. In many cases it could be overlooked, because there is no noticeable external injury, no witness to the incident, and the abuser do not admit to the incident. CNS trauma is one of the most serious form of injury found among the victims of physical abuse which may result in intracranial hemorrhage and contusions. The head injuries are
It helps to verify the consistency of the report by the caretaker and their explanation of the times of injury. Age dating of bruises can often be determined by looking at the color of the bruise. The ages and colors of bruises may therefore show if more than one injury is present. Dating of boney injuries is very important while suspecting a physical abuse. It could help the investigators find out, who was present at the child’s side, when the injury happened. It also help them to estimate the time of the incidence. Researchers have found out, that fractured long bones and ribs heal in a predictable manner, which is divided into the following 4 stages: initial healing, soft callus, hard callus, and remodeling. The stage of healing could be estimated after identifying the time of injury. Bones of young children tends to heal more rapidly than in older children and adults. Recent findings regarding the dating of fractures, emphasized on the results of histologic specimens rather than radiologic films. It is being suggested by the researchers, that the healthcare providers should be careful, in precisely dating fracture age based on the x-ray findings only (Giardino,